Individual provider Active NPI

Tyna Marie Halvorson, LPN

  • Licensed Practical Nurse
  • Grand Forks, ND
National Provider Identifier
1003789843
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L12807 Issued in ND
Practice address
3221 32ND Ave S Ste 700
Grand Forks, ND 58201-6075
Phone
(701) 239-3700
NPI assigned
Sep 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L12807 ND Primary

Addresses

Primary practice location

3221 32ND Ave S Ste 700
Grand Forks, ND 58201-6075

Mailing address

631 Great Plains CT
Grand Forks, ND 58201-7747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L12807NDMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1003789843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 GREAT PLAINS CT",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582017747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 32ND AVE S STE 700",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016075",
            "telephone_number": "701-239-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "TYNA",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "ND",
            "license": "L12807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.