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General NPI Number Information
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NPI Number | 1265230874
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Entity Type | Individual
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Provider Name | PATRICK YVAN TAPP
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Gender | Male
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 7505 METRO BLVD STE 505
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City | EDINA
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State | MN
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Zip | 55439-3018
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Country | US
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Telephone | 651-271-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 510 HUSET PKWY NE
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City | COLUMBIA HEIGHTS
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State | MN
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Zip | 55421-5030
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Country | US
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Telephone | 612-812-0286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 13129
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 2476128
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License Number State | MN
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