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Individual

SARAH TAGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
111 HUNDERTMARK RD STE 205N, CHASKA, MN 55318-1586
(952) 903-1350
Mailing address
5212 PARK AVE, MINNEAPOLIS, MN 55417-1718
(563) 379-2103

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
2200840
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5659
MN

Other

Enumeration date
01/09/2018
Last updated
01/31/2018
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