Basic Information
| Provider Information | |||||||||
| NPI: | 1811251507 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TEKIPPE | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1309, 8170 33RD AVE S. | ||||||||
| Address2: | MS 21110Q | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554254516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512548300 | ||||||||
| FaxNumber: | 6512548379 | ||||||||
| Practice Location | |||||||||
| Address1: | 435 PHALEN BLVD | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551305302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512548300 | ||||||||
| FaxNumber: | 6512548379 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2012 | ||||||||
| LastUpdateDate: | 05/13/2019 | ||||||||
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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 | 207P00000X | 65331-20 | WI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PS0010X | 57114 | MN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Sports Medicine | 207P00000X | 57114 | MN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.