Healthcare Provider Details

I. General information

NPI: 1891699633
Provider Name (Legal Business Name): TANYA KOHANDEL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WASHINGTON AVE S STE 1210
MINNEAPOLIS MN
55401-2511
US

IV. Provider business mailing address

100 WASHINGTON AVE S STE 1210
MINNEAPOLIS MN
55401-2511
US

V. Phone/Fax

Practice location:
  • Phone: 866-492-5336
  • Fax: 612-338-5092
Mailing address:
  • Phone: 866-492-5336
  • Fax: 612-338-5092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberF09261676
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: