Basic Information
| Provider Information | |||||||||
| NPI: | 1639342009 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FREITAG | ||||||||
| FirstName: | TASHA | ||||||||
| MiddleName: | BECK | ||||||||
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| Credential: | CRNP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BECK | ||||||||
| OtherFirstName: | TASHA | ||||||||
| OtherMiddleName: | ANNE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6300 SHINGLE CREEK PKWY STE 600 | ||||||||
| Address2: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554302127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637826400 | ||||||||
| FaxNumber: | 7637829558 | ||||||||
| Practice Location | |||||||||
| Address1: | 420 DELAWARE STREET SE MMC 126 | ||||||||
| Address2: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554550341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637826400 | ||||||||
| FaxNumber: | 7637829558 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2008 | ||||||||
| LastUpdateDate: | 07/30/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R162362 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | SP013581 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 3897 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.