Provider Demographics
NPI:1144439134
Name:TAUER, JUDITH ANN (RNC,ANP)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:TAUER
Suffix:
Gender:F
Credentials:RNC,ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2356 UNIVERSITY AVE W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1853
Mailing Address - Country:US
Mailing Address - Phone:651-556-0887
Mailing Address - Fax:
Practice Address - Street 1:2356 UNIVERSITY AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1853
Practice Address - Country:US
Practice Address - Phone:651-556-0887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR067966-4363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health