Provider Demographics
NPI:1780045930
Name:MEISNER, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:MEISNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 146TH ST W
Mailing Address - Street 2:324
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-3189
Mailing Address - Country:US
Mailing Address - Phone:651-242-0520
Mailing Address - Fax:
Practice Address - Street 1:2930 146TH ST W
Practice Address - Street 2:324
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-3189
Practice Address - Country:US
Practice Address - Phone:651-242-0520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist