Healthcare Provider Details

I. General information

NPI: 1275477002
Provider Name (Legal Business Name): ANNE CHRISTINE TATRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 ARCADE ST
SAINT PAUL MN
55106-2069
US

IV. Provider business mailing address

360 COLBORNE ST
SAINT PAUL MN
55102-3299
US

V. Phone/Fax

Practice location:
  • Phone: 651-888-7620
  • Fax:
Mailing address:
  • Phone: 651-728-7055
  • Fax: 651-305-5456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number1568198
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: