Provider Demographics
NPI:1811419641
Name:MUSSE, ASAD J (RN)
Entity Type:Individual
Prefix:
First Name:ASAD
Middle Name:J
Last Name:MUSSE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3249 HENNEPIN AVE STE 60
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3470
Mailing Address - Country:US
Mailing Address - Phone:952-400-7878
Mailing Address - Fax:
Practice Address - Street 1:1607 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-1605
Practice Address - Country:US
Practice Address - Phone:612-216-5234
Practice Address - Fax:612-216-5234
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2404015163WH0200X, 163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WH0200XNursing Service ProvidersRegistered NurseHome Health