Healthcare Provider Details

I. General information

NPI: 1780925958
Provider Name (Legal Business Name): CYNTHIA LU TOMPKINS RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA LU KREZEK

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 JACKSON ST # MS 11502V
SAINT PAUL MN
55101-2502
US

IV. Provider business mailing address

8170 33RD AVE S # MS 21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-7980
  • Fax: 651-254-7990
Mailing address:
  • Phone: 651-254-7980
  • Fax: 952-853-8727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number124800-1
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number0380
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0380
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: