Tiffany Alicia Axtman
Nurse Practitioner in Bemidji, MN. Individual provider (NPI-1).
NPI number1699397042
StatusActive
Last updated in NPPESAug 9, 2022
Details
- NPI
- 1699397042
- Entity type
- Individual (NPI-1)
- Name
- Tiffany Alicia Axtman
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 8, 2020
- Certification date
- Aug 9, 2022
- Last updated
- Aug 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 7254 | MN | Yes |
Practice location
1611 Anne St NwBemidji, MN 56601-5114
Phone 218-333-5000
Mailing address
Po Box 5074Sioux Falls, SD 57117-5074
Phone 600-532-8658
Other practice locations
1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Grand Rapids, MN 55744-8648
Phone 218-326-3401
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