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NPI Code Detail

MEDICARE: TIFFANY AWOWALE NP

MEDICARE: TIFFANY AWOWALE NP
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
1363L00000XNurse Practitioner13083MN
2363LA2100XAcute Care Nurse Practitioner13083MN

General Provider Information

NPI Number : 1659230209
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY AWOWALE NP
Provider Business Mailing Address
First Line : 2925 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1321
Country : US
Telephone Number : 612-262-5000
Fax Number :
Provider Business Practice Location Address
First Line : 2925 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1321
Country : US
Telephone Number : 612-863-4000
Fax Number : 763-236-3026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/27/2026

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