Provider Demographics
NPI:1639342009
Name:FREITAG, TASHA BECK (CRNP)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:BECK
Last Name:FREITAG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:ANNE
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6300 SHINGLE CREEK PKWY STE 600
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2127
Mailing Address - Country:US
Mailing Address - Phone:763-782-6400
Mailing Address - Fax:763-782-9558
Practice Address - Street 1:420 DELAWARE STREET SE MMC 126
Practice Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:763-782-6400
Practice Address - Fax:763-782-9558
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR162362363LF0000X
PASP013581363LF0000X
MN3897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA339344EZ3Medicare PIN