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NPI Code Detail

MEDICARE: ANGELA TARCON APRN, CNP

MEDICARE: ANGELA TARCON APRN, CNP
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
1363L00000XNurse PractitionerR2469878MN
2363L00000XNurse Practitioner192990TN
3363LF0000XFamily Nurse Practitioner6412MN
4363L00000XNurse PractitionerCNP6412MN

General Provider Information

NPI Number : 1568965200
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA TARCON APRN, CNP
Provider Business Mailing Address
First Line : 5400 EXCELSIOR BLVD
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-2913
Country : US
Telephone Number : 952-993-1000
Fax Number :
Provider Business Practice Location Address
First Line : 5400 EXCELSIOR BLVD
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-2913
Country : US
Telephone Number : 952-993-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2018
Last Update Date : 08/05/2019

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