Provider Demographics
NPI:1144416728
Name:HULDEEN-TIBBETTS, ANDRAYA J (MD)
Entity Type:Individual
Prefix:
First Name:ANDRAYA
Middle Name:J
Last Name:HULDEEN-TIBBETTS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:560 S MAPLE ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-1733
Mailing Address - Country:US
Mailing Address - Phone:952-442-2137
Mailing Address - Fax:952-442-5904
Practice Address - Street 1:560 S MAPLE ST
Practice Address - Street 2:SUITE 130
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1733
Practice Address - Country:US
Practice Address - Phone:952-442-2137
Practice Address - Fax:952-442-5904
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN50517207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology