Individual
MS. TINA MARIE ALLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3300 OAKDALE AVE N, SUITE 200, MINNEAPOLIS, MN 55422-2926
(763) 520-2000
(763) 520-2099
Mailing address
4905 W 66TH STREET, EDINA, MN 55435
(612) 396-0553
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R119816-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3054977-00
—
MN
05
—
43995700
—
WI
Enumeration date
08/31/2006
Last updated
09/10/2008
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