Individual provider Active NPI

Tatianna Pollak, PHARMD

  • Emergency Medicine Pharmacist
  • Fargo, ND
National Provider Identifier
1629952775
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PharmacistTaxonomy code 1835E0208X
License
125414 Issued in MN
Practice address
3000 32ND Ave S
Fargo, ND 58103-6132
Phone
(701) 364-8000
NPI assigned
Aug 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Pharmacist 1835E0208X 125414 MN Primary
Emergency Medicine Pharmacist 1835E0208X RPH6508 ND

Addresses

Primary practice location

3000 32ND Ave S
Fargo, ND 58103-6132

Mailing address

4014 Kultala Rd
Cloquet, MN 55720-9311
Phone (218) 461-2292

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
125414MNMDMedical license number
RPH6508NDMDMedical license number

NPI Registry JSON

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

{
    "created_epoch": "1754092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1629952775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 KULTALA RD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557209311",
            "telephone_number": "218-461-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLAK",
        "first_name": "TATIANNA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-02",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835E0208X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Emergency Medicine",
            "state": "MN",
            "license": "125414",
            "primary": true
        },
        {
            "code": "1835E0208X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Emergency Medicine",
            "state": "ND",
            "license": "RPH6508",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.