Provider Demographics
NPI:1629040639
Name:TA, KAREN P (MD)
Entity Type:Individual
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First Name:KAREN
Middle Name:P
Last Name:TA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:651-730-1700
Practice Address - Street 1:1811 WEIR DRIVE SUITE 355 - MAIL STOP 13701A
Practice Address - Street 2:HEALTHPARTNERS REGIONS BEHAVIORAL HEALTH-WOODBURY
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2273
Practice Address - Country:US
Practice Address - Phone:651-254-8580
Practice Address - Fax:651-730-1700
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2011-12-05
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Provider Licenses
StateLicense IDTaxonomies
MN351012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN811818300Medicaid
F77222Medicare UPIN
MN260001426Medicare ID - Type Unspecified