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Individual

TANYA WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
424 HARVARD STREET SE, FIRST FLOOR, SUITE M100 - MASONIC CANCER CENTER, MINNEAPOLIS, MN 55455
(612) 625-5411
Mailing address
420 DELAWARE STREET SE, MMC 292 - UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 625-5411

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R 137091-7
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-05250
UCARE
MN
01
1033396
PREFERREDONE
MN
01
1787201
ARAZ
MN
05
4301310
MT
01
495A6WA
BLUE CROSS BLUE SHIELD MN
MN
05
787633500
MN
01
HP40589
HEALTHPARTNERS
MN
Enumeration date
09/20/2006
Last updated
10/29/2012
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