Individual
TASHA KIBERENGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
3244 HUMBOLDT AVE S, MINNEAPOLIS, MN 55408-3328
(612) 839-2955
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
12085
MN
Other
Enumeration date
09/08/2015
Last updated
02/24/2022
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