TIFFANY S HALL (NPI# 1205012424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205012424 |
| Entity Type | Individual |
| Full Name | TIFFANY S HALL |
| Other Name | TIFFANY S KALAR |
| Credential | PA-C |
| Practice Address |
1500 109th Ave Ne Blaine MN 55449 |
| Mailing Address |
1500 109th Ave Ne Blaine MN 55449-4670 |
| Practice Telephone | 7634215011 |
| Mailing Telephone | 7634215011 |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2019-01-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10653 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1500 109th Ave Ne, Blaine, MN 554494670 | 7634215011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375352 | Tiffany Lauren Hall | Nurse Practitioner | 308 W Rock Island, Boyd, TX 76023 | 2020-10-30 |
| 1265047880 | Tiffany Ann Hall | Technician | 200 Vicie Newsome Road, Kermit, WV 25674 | 2020-09-10 |
| 1699387662 | Tiffany Ann Hall | Technician | 1883 Highway 2037, Louisa, KY 41230-8266 | 2020-08-20 |
| 1538784707 | Tiffany Cherie Hall | Counselor | 1219 10th St, Eureka, CA 95501-2024 | 2020-06-12 |
| 1164043451 | Tiffany Hall | Chiropractor | 4217 Swiss Ave Apt 326, Dallas, TX 75204-6683 | 2020-04-28 |
| 1093090748 | Tiffany Danielle Hall | Counselor | 3410 Healy Dr Ste 201c, Winston Salem, NC 27103-1568 | 2011-10-13 |
| 1184894834 | Tiffany Hall | Counselor | 700 Stone Lion Dr, Apt 735, Durham, NC 27703-6171 | 2008-03-10 |
| 1598780546 | Tiffany Hall | Internal Medicine | 3725 Champion Hills Dr Ste 2000, Memphis, TN 38125-0502 | 2006-07-12 |
| 1659377059 | Tiffany N Hall | Obstetrics & Gynecology | 3050 Mack Rd Ste 375, Fairfield, OH 45014-5378 | 2005-06-22 |
| 1396351052 | Tiffany T Hall | Counselor | 4023 Marine Ave, Lawndale, CA 90260-1840 | 2020-09-18 |
| Street Address |
1500 109TH AVE NE |
| City | BLAINE |
| State | MN |
| Zip Code | 55449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336117480 | Maisa Alves Pebbles | Nurse Practitioner | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2006-03-14 |
| 1235618976 | Phurbu Tara | Nurse Practitioner | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2018-08-13 |
| 1245778612 | Angela Laughlin | Nurse Practitioner | 1500 109th Ave Ne, Minute Clinic, Blaine, MN 55449-4670 | 2017-02-06 |
| 1043670730 | Alisha Duffy Mcafee | Optometrist | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2016-02-24 |
| 1487028627 | Charles Ruegemer | Physician Assistant | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2015-11-28 |
| 1366814139 | Joseph James Leveille | Physician Assistant | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2015-10-20 |
| 1053752527 | Abby Hannah Haugrud | Pharmacist | 1500 109th Ave Ne, T1832, Blaine, MN 55449-4670 | 2013-07-12 |
| 1700221744 | Mary M Laplant | Pharmacist | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2013-05-03 |
| 1578804514 | Rebecca J Cebuhar | Pharmacist | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2013-03-14 |
| 1447544291 | Stephanie Simpson | Pharmacist | 1500 109th Ave Ne, T-1832, Blaine, MN 55449-4670 | 2011-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736368 | Landon Thomas Case | Dentist | 10729 Town Square Drive Ne, Ste 100, Blaine, MN 55449 | 2020-07-02 |
| 1881168441 | Ear Institutes, LLC | Otolaryngology | 4365 Pleasant Ridge Dr Ne, Suite 106, Blaine, MN 55449 | 2019-01-17 |
| 1841776242 | Kristin Broback | Nurse Practitioner | 10705 Town Square Dr Ne #100, Blaine, MN 55449 | 2018-07-18 |
| 1043719016 | Robin Lynn Broen | Registered Nurse | 3012 129th Ave Ne, Blaine, MN 55449 | 2018-02-06 |
| 1194197368 | Lund Health Professional Corporation | Chiropractor | 1360 101st Ave Ne, Suite 140, Blaine, MN 55449 | 2015-10-27 |
| 1871989806 | Blaine Wp II, LLC | Assisted Living Facility | 12402 Jamestown Street Ne, Blaine, MN 55449 | 2015-04-07 |
| 1154761633 | Jean Budge | Marriage & Family Therapist | 11800 Aberdeen Street Ne, Suite 100, Blaine, MN 55449 | 2013-06-28 |
| 1295013498 | Jeff K Yu | Veterinarian | 11850 Aberdeen St Ne, Blaine, MN 55449 | 2011-07-22 |
| 1528394707 | Julie Ann Eibensteiner | Physical Therapist | 11304 Davenport Circle Ne #a, Minneapolis, MN 55449 | 2009-10-23 |
| 1871725333 | Deborah Kathryn Zongo | Nurse Practitioner | 10190 Baltimore St Ne Ste 100, Blaine, MN 55449 | 2009-08-18 |
| Find all providers in zip 55449 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861787343 | Rachel Lynn Enge | Physician Assistant | 11855 Ulysses Street Ne, Blaine, MN 55434 | 2011-06-13 |
| 1386288793 | Dennis Taylor Jorgenson-rathke | Physician Assistant | 11091 Ulysses St Ne Ste 100, Blaine, MN 55434-4238 | 2019-10-30 |
| 1629623525 | Rebecca Lenore Ertsgaard | Physician Assistant | 11091 Ulysses St Ne Ste 100, Blaine, MN 55434-4238 | 2019-08-07 |
| 1487028627 | Charles Ruegemer | Physician Assistant | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2015-11-28 |
| 1366814139 | Joseph James Leveille | Physician Assistant | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2015-10-20 |
| 1629405931 | Rachel Sinnen | Physician Assistant | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2013-10-01 |
| 1013165638 | Shaun Sava | Physician Assistant | 10961 Club West Pkwy, Blaine, MN 55449-5866 | 2008-09-08 |
| 1841338449 | Beth Olson | Physician Assistant | 10190 Baltimore St Ne, Blaine, MN 55449-5056 | 2007-02-03 |
| 1760539746 | Michelle Manos | Physician Assistant | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2007-01-04 |
| 1104800358 | John W Stoulil | Physician Assistant | 12175 Aberdeen St Ne, Blaine, MN 55449-4717 | 2005-12-01 |
| Find all providers in BLAINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.