TIFFANY RAE KREBSBACH (NPI# 1023552924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023552924 |
| Entity Type | Individual |
| Full Name | TIFFANY RAE KREBSBACH |
| Practice Address |
6500 Excelsior Blvd St Louis Park MN 55426-4702 |
| Practice Telephone | 9529933246 |
| Mailing Telephone | 9529933246 |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2016-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP 4267 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6500 EXCELSIOR BLVD |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55426-4702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861484669 | Robert E Haselow | Radiology | 6500 Excelsior Blvd, Methodist Radiation Therapy, St Louis Park, MN 55426-4702 | 2005-08-17 |
| 1215549381 | Katelyn Boys | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-08-20 |
| 1386253466 | Christine Harlander | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2020-07-24 |
| 1063021210 | Ian-thomas Campbell-groen | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2020-07-23 |
| 1619585387 | Kelly Faber | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-07-20 |
| 1952938821 | Paige Rygg | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-03-23 |
| 1801427406 | Brandi Jo St. Mane | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-02-01 |
| 1811528680 | Brian Servey IIi | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-01-30 |
| 1245873421 | Weston Poucher | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2019-10-21 |
| 1427609973 | Lauren Damrow | Registered Nurse | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2019-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124636063 | Kellie Lynn Leblanc | Nurse Practitioner | 3151 Hillsboro Ave S, St Louis Park, MN 55426-2930 | 2020-07-16 |
| 1861471666 | Jennifer L Mears | Nurse Practitioner | 5525 Cedar Lake Rd S, St Louis Park, MN 55416-1420 | 2006-01-11 |
| 1467440784 | Leann Clarksean | Nurse Practitioner | 5320 W 23rd St Ste 130, St Louis Park, MN 55416-1670 | 2005-10-11 |
| 1447259395 | Ann Kolar Chinnakotla | Nurse Practitioner | 3900 Park Nicollet Blvd, 3rd Floor Urology, St Louis Park, MN 55416-2503 | 2005-07-21 |
| 1629611033 | Johanna Clara Ayers | Nurse Practitioner | 4656 Excelsior Blvd, St Louis Park, MN 55416-4938 | 2019-10-18 |
| 1790290195 | Kathryn Caye Mcgovern | Nurse Practitioner | 4656 Excelsior Blvd, St Louis Park, MN 55416-4938 | 2017-12-06 |
| 1912422718 | Kathleen Therese Guinee Holman | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2017-08-14 |
| 1619497476 | Laura I. Lenz | Nurse Practitioner | 3850 Park Nicollet Blvd, St Louis Park, MN 55416 | 2017-06-22 |
| 1871013037 | Lorraine Marie Richards | Nurse Practitioner | 3931 Louisiana Ave S, St Louis Park, MN 55426-5000 | 2017-06-20 |
| 1568848331 | Shannon Lee Hoversten | Nurse Practitioner | 3931 Louisiana Ave S, St Louis Park, MN 55426-5000 | 2015-08-04 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55426 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.