Individual
JULIE MARIE TAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6300
Mailing address
9322 83RD ST S, COTTAGE GROVE, MN 55016-3486
(651) 402-4855
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
180558-30
WI
163W00000X
Registered Nurse
R 166268-3
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
103372
MN
Other
Enumeration date
06/03/2014
Last updated
10/02/2014
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