Individual
JUDITH ANN TIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1313 PENN AVE N, MINNEAPOLIS, MN 55411-3047
(612) 302-4600
(612) 302-4870
Mailing address
615 1ST AVE NE, STE 310, MINNEAPOLIS, MN 55413-2419
(612) 302-4600
(612) 302-4870
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R-046467-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147853900
—
MN
Enumeration date
08/11/2006
Last updated
08/18/2016
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