Healthcare Provider Details

I. General information

NPI: 1891733440
Provider Name (Legal Business Name): TANYA C MULLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 WASHINGTON AVE N FL 2
MINNEAPOLIS MN
55401-1619
US

IV. Provider business mailing address

121 WASHINGTON AVE N FL 2
MINNEAPOLIS MN
55401-1619
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number11275
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR-155072-4
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: