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General NPI Number Information
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NPI Number | 1447021985
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Entity Type | Organization
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Legal Business Name | TRANQUIL MINDS PSYCHIATRY
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 402 3RD ST E STE 12
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City | ADA
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State | MN
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Zip | 56510-1404
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Country | US
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Telephone | 218-394-2774
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Fax | 218-394-2780
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Provider Business Mailing Address
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Address Line | 402 3RD ST E STE 12
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City | ADA
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State | MN
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Zip | 56510-1404
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Country | US
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Telephone | 218-394-2774
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Fax | 218-394-2780
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | NICOLE CHERIE ALBAUGH
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Credential | APRN - PMHNP
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Telephone | 218-394-2774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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