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Individual

TANYA L. HALVORSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
347 SMITH AVE N, SAINT PAUL, MN 55102-2387
(651) 220-6818
(651) 220-6064
Mailing address
347 SMITH AVE N, SAINT PAUL, MN 55102-2387
(651) 220-6818
(651) 220-6064

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
45340
MN
2080P0205X
Pediatric Endocrinology Physician
Primary
45340
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
978163300
MN
Enumeration date
10/27/2006
Last updated
06/26/2015
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