Provider Demographics
NPI:1801616248
Name:TRANQUIL MINDS MENTAL HEALTH
Entity type:Organization
Organization Name:TRANQUIL MINDS MENTAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOBRAVA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP, PMHNP-BC
Authorized Official - Phone:701-500-0791
Mailing Address - Street 1:8245 W BEATRICE DR
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55319
Mailing Address - Country:US
Mailing Address - Phone:701-500-0794
Mailing Address - Fax:
Practice Address - Street 1:8245 W BEATRICE DR
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55319
Practice Address - Country:US
Practice Address - Phone:701-500-0794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty