1063105898 NPI number — ZAIN NUTRITIONAL THERAPY CLINIC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063105898 NPI number — ZAIN NUTRITIONAL THERAPY CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZAIN NUTRITIONAL THERAPY CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063105898
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3800 AMERICAN BLVD W STE 1500
Provider Second Line Business Mailing Address:
SUITE 1500
Provider Business Mailing Address City Name:
BLOOMINGTON
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55431-4429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-432-3628
Provider Business Mailing Address Fax Number:
612-808-5135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 NICOLLET AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55403-3791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-432-3628
Provider Business Practice Location Address Fax Number:
612-808-5135
Provider Enumeration Date:
05/29/2023

Additional Information

Authorized Official

Authorized Official Last Name:
ALOL
Authorized Official First Name:
ZEINAB
Authorized Official Middle Name:
ABDI JAMA
Authorized Official Title or Position:
LICENSED DIETITIAN NUTRITIONIST
Authorized Official Telephone Number:
612-432-3628

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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