KAY L TYBERG GNP NPI 1942247861

NPI Information

NPI: 1942247861
Provider Name: KAY L TYBERG, GNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: HENNEPIN HEALTHCARE SYSTEM INC

PECOS Registration: Yes

Address:
701 PARK AVE
MINNEAPOLIS, MN
ZIP 55415
Phone: (612) 873-4105
Get Directions

Kay L Tyberg, GNP is a gerontology nurse practitioner in Minneapolis, MN with 42 years of experience. Kay L Tyberg, GNP NPI is 1942247861. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

701 PARK AVE
MINNEAPOLIS, MN
ZIP 55415-623
Phone: (612) 873-4105
Fax: (612) 904-4644

The NPI 1942247861 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 11/2/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	2006001671	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	575324400	MEDICAID	MINNESOTA
2	500003495	MEDICARE OSCAR/CERTIFICATION	MINNESOTA
3	04-08776	OTHER	MINNESOTA	MEDICA
4	500003690	MEDICARE OSCAR/CERTIFICATION	MINNESOTA
5	Q71525	MEDICARE UPIN	MINNESOTA
6	025N3TY	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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