Tyberg, Kay L

Tyberg, Kay L is an individual health care provider with primary practice located at 701 Park Ave , Minneapolis MN 55415-1623. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Tyberg, Kay L can be contacted via phone (612) 873-4105.

Contact Information

Primary practice address
701 Park Ave Minneapolis MN 55415-1623
Phone: (612) 873-4105
Fax: (612) 904-4644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 2006001671 Minnesota

Profile Details

NPI number 1942247861
LBN Legal business name Tyberg, Kay L
Credentials Gerontological Nurse Practitioner (GNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Nov 2nd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942247861 NPPES
Minnesota Other 025N3TY BLUE CROSS BLUE SHIELD
Minnesota Other 04-08776 BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 575324400 BLUE CROSS BLUE SHIELD

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