Provider Demographics
NPI:1518689751
Name:OBSE, TIGIST OSMAN (NONMEDICAL TRANSPORT)
Entity Type:Individual
Prefix:
First Name:TIGIST
Middle Name:OSMAN
Last Name:OBSE
Suffix:
Gender:F
Credentials:NONMEDICAL TRANSPORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 142ND ST E
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-2476
Mailing Address - Country:US
Mailing Address - Phone:952-484-2484
Mailing Address - Fax:952-885-6925
Practice Address - Street 1:13919 ASHFORD PATH
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-3923
Practice Address - Country:US
Practice Address - Phone:952-484-2484
Practice Address - Fax:952-885-6925
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty