MEDICARE: BARBARA ANN TJEPKES WHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1189221	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235101411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA ANN TJEPKES WHNP

Provider Business Mailing Address
First Line	:	6845 LEE AVE N
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55429-1717
Country	:	US
Telephone Number	:	763-503-4400
Fax Number	:	763-569-0311

Provider Business Practice Location Address
First Line	:	6845 LEE AVE N
Second Line	:	MAIL STOP 31400A
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55429-1717
Country	:	US
Telephone Number	:	763-569-0300
Fax Number	:	763-569-0330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	08/11/2015

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