Mariya Tkachenko, CNP
Nurse Practitioner, Family in Shakopee, MN. Individual provider (NPI-1).
NPI number1295565679
StatusActive
Last updated in NPPESSep 9, 2024
Details
- NPI
- 1295565679
- Entity type
- Individual (NPI-1)
- Name
- Mariya Tkachenko
- Credential
- CNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 1, 2024
- Certification date
- Sep 9, 2024
- Last updated
- Sep 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 11902 | MN | Yes |
| 363L00000X | Nurse Practitioner | 11902 | MN |
Practice location
1415 Saint Francis AveShakopee, MN 55379-3374
Phone 952-993-7750
Mailing address
8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516
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All 19 Family Nurse Practitioner providers in Shakopee · All 901 providers in Shakopee
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