Provider Demographics
NPI:1952121253
Name:AASAND, ADRIENNE JO (CNP)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:JO
Last Name:AASAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N6387 1307TH ST
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:WI
Mailing Address - Zip Code:54021-7022
Mailing Address - Country:US
Mailing Address - Phone:763-458-4649
Mailing Address - Fax:
Practice Address - Street 1:1580 BEAM AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1127
Practice Address - Country:US
Practice Address - Phone:651-779-7978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-12
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16049-33363LA2200X, 363LG0600X
MN12169363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology