Individual provider Active NPI

Anne Nathanaelle Tristant

  • Behavior Technician
  • Lakeville, MN
National Provider Identifier
1205647286
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
10450 185TH St W Ste 100
Lakeville, MN 55044-6696
Phone
(612) 509-6690
NPI assigned
Jan 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X MN Primary

Addresses

Primary practice location

10450 185TH St W Ste 100
Lakeville, MN 55044-6696

Mailing address

1571 Lafond Ave
Saint Paul, MN 55104-1817
Phone (305) 780-4400

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

NPI Registry JSON

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1205647286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 LAFOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041817",
            "telephone_number": "305-780-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 185TH ST W STE 100",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446696",
            "telephone_number": "612-509-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRISTANT",
        "first_name": "ANNE",
        "middle_name": "NATHANAELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.