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Individual

TASHITAA TUFAA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PRESIDENT & CEO

Contact information

Practice address
8260 HICKORY ST NE, FRIDLEY, MN 55432-1002
(763) 571-1541
(763) 541-1547
Mailing address
8260 HICKORY ST NE, FRIDLEY, MN 55432-1002
(763) 571-1541
(763) 541-1547

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
370010
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9JI05ME
BCBS
MN
01
A392138100
MHCP
MN
Enumeration date
01/14/2016
Last updated
01/14/2016
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