Provider Demographics
NPI:1831781897
Name:ALI, MUNA
Entity type:Individual
Prefix:
First Name:MUNA
Middle Name:
Last Name:ALI
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 1:3001 4TH ST SE APT 511
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-7578
Mailing Address - Country:US
Mailing Address - Phone:612-978-4272
Mailing Address - Fax:
Practice Address - Street 1:3001 4TH ST SE APT 511
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-7578
Practice Address - Country:US
Practice Address - Phone:612-978-4272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1105421146D00000X, 171M00000X, 372600000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No372600000XNursing Service Related ProvidersAdult Companion