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Individual

ROBERT TACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
209 3RD ST NE, WAITE PARK, MN 56387-1271
(320) 968-6023
Mailing address
209 3RD ST NE, WAITE PARK, MN 56387-1271

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
14074
MN

Other

Enumeration date
04/30/2026
Last updated
04/30/2026
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