TYLER JOHN STEVENS (NPI# 1629630488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629630488 |
| Entity Type | Individual |
| Full Name | TYLER JOHN STEVENS |
| Credential | PHARMD |
| Practice Address |
1555 Northway Dr Ste 200 Saint Cloud MN 56303-4913 |
| Mailing Address |
87 99th Ave Nw Coon Rapids MN 55448-5212 |
| Practice Telephone | 3202403157 |
| Practice Fax Number | 3202403164 |
| Mailing Telephone | 6122504178 |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
124294 | MN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114904729 | Tyler K Stevens | Internal Medicine | 4095 Meadowbrook Blvd, University Heights, OH 44118-3854 | 2005-12-23 |
| Street Address |
1555 NORTHWAY DR STE 200 |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437106986 | Clarice Hanks Konshok | Family Medicine | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2006-05-30 |
| 1841802436 | Lauren Renae Martens | Pharmacist | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-08-17 |
| 1043832132 | Sadio Ahmed Mohamed | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-05-12 |
| 1093336299 | Jennifer Ann Tarpenning | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-04-29 |
| 1144840463 | Bashir Moallin | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-04-17 |
| 1679193957 | Seth Nelson | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-04-16 |
| 1346860632 | Svetlana Adusheva | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-04-16 |
| 1851942007 | Elizabeth Louise Fiedler | Nurse Practitioner | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2019-09-27 |
| 1417511270 | John Evenocheck | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2019-04-26 |
| 1447813431 | Oluwatobi Olushoga Falade | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2019-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063074235 | Briana Gray | Pharmacist | 1200 6th Ave N, Internal Medicine, Saint Cloud, MN 56303-2735 | 2019-07-08 |
| 1386200988 | Victor Peguero Perez | Pharmacist | 4501 13th St, Saint Cloud, FL 34769-6742 | 2019-05-20 |
| 1912483363 | Jenna Rae Gullickson | Pharmacist | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2018-07-18 |
| 1346736261 | Nathan Beckman | Pharmacist | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2018-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124637145 | Nelson Nudd | Pharmacist | 4104 Zenith Ave S, Minneapolis, MN 55410-1156 | 2020-07-26 |
| 1609424712 | Fredrick Victor Parduhn | Pharmacist | 425 Sandy Ln, Red Wing, MN 55066-1759 | 2019-09-01 |
| 1386298859 | Anna Mckay Fox | Pharmacist | 4000 28th Avenue S, Moorhead, MN 56560 | 2019-08-01 |
| 1386160109 | Hayley Retaskie | Pharmacist | 2025 Sloan Pl Ste 35, Saint Paul, MN 55117-2092 | 2017-08-15 |
| 1104341932 | Logane Kiehnau | Pharmacist | 150 Emerson Ave E # E, West St Paul, MN 55118-2535 | 2017-08-14 |
| 1154773265 | Kailee Donner | Pharmacist | 701 Park Ave Rll. 120, Minneapolis, MN 55415 | 2016-07-13 |
| 1346600962 | Julie Corradi | Pharmacist | 5219 St. Johns Drive, Nett Lake, MN 55772 | 2016-02-24 |
| 1386993871 | Oluwaseyi Faseemo | Pharmacist | 314 Elton Hills Dr Nw, Rochester, MN 55901-2476 | 2012-08-30 |
| 1063011021 | Zeleke Belay Goshu | Pharmacist | 15300 Grove Cir N, Maple Grove, MN 55369-4469 | 2020-10-21 |
| 1972111003 | Alexandra Michele Vecchia | Pharmacist | 6545 France Ave S, Edina, MN 55435-2131 | 2020-07-15 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.