Provider Demographics
NPI:1255950697
Name:ADEN, ANAB ALI
Entity type:Individual
Prefix:
First Name:ANAB
Middle Name:ALI
Last Name:ADEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 EDEN RD APT 450
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7605
Mailing Address - Country:US
Mailing Address - Phone:612-701-0670
Mailing Address - Fax:612-353-5158
Practice Address - Street 1:8080 EDEN RD APT 450
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7605
Practice Address - Country:US
Practice Address - Phone:612-701-0670
Practice Address - Fax:612-353-5158
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide