MEDICARE: MS. JUDITH ANN TAUER RNC,ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	R067966-4	MN

General Provider Information

NPI Number	:	1144439134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH ANN TAUER RNC,ANP

Provider Business Mailing Address
First Line	:	2356 UNIVERSITY AVE W
Second Line	:	SUITE 210
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1853
Country	:	US
Telephone Number	:	651-556-0887
Fax Number	:

Provider Business Practice Location Address
First Line	:	2356 UNIVERSITY AVE W
Second Line	:	SUITE 210
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1853
Country	:	US
Telephone Number	:	651-556-0887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	04/30/2009

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