Individual
DR. JENNIFER M TAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 SIXTH AVE N, ST CLOUD, MN 56303-2735
(320) 251-2700
(320) 240-3143
Mailing address
1200 SIXTH AVE N, ST CLOUD, MN 56303-2735
(320) 251-2700
(320) 240-3143
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
56740
MN
208M00000X
Hospitalist Physician
Primary
56740
MN
390200000X
Student in an Organized Health Care Education/Training Program
PERMIT24771
MN
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/29/2012
Last updated
05/19/2015
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