Individual
TARA HEINSELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 365-1000
Mailing address
4972 PRAIRIE SPRING CT, WAUNAKEE, WI 53597-8967
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2772
MN
367500000X
Certified Registered Nurse Anesthetist
52912-30
WI
390200000X
Student in an Organized Health Care Education/Training Program
236170-5
MN
390200000X
Student in an Organized Health Care Education/Training Program
252912-30
WI
Other
Enumeration date
09/13/2022
Last updated
04/19/2023
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