Active NPI
Tara Lahaise, R.N.
- Registered Nurse
- Minneapolis, MN
National Provider Identifier
1104174549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R 193089-4
- Practice address
- 2833 Lyndale Ave S
135
Minneapolis, MN 55408-2153 - Phone
- (612) 990-0502
- NPI assigned
- Aug 15, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R 193089-4 | MN | Primary |
Addresses
Primary practice location
2833 Lyndale Ave S
135
Minneapolis, MN 55408-2153
Mailing address
2833 Lyndale Ave S
135
Minneapolis, MN 55408-2153
Phone (612) 990-0502
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 193089-4 | MN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1104174549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2833 LYNDALE AVE S",
"address_2": "135",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082153",
"telephone_number": "612-990-0502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2833 LYNDALE AVE S",
"address_2": "135",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082153",
"telephone_number": "612-990-0502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAHAISE",
"first_name": "TARA",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-15",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "R 193089-4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.