Jill D Tabaka, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R2073501 Issued in MN

Practice address

1 Veterans Dr
Minneapolis, MN 55417-2309

Phone

(612) 725-2000

NPI assigned

Jul 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1689016370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19442 CENTURY RD",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550241581",
            "telephone_number": "507-269-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-725-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABAKA",
        "first_name": "JILL",
        "middle_name": "D",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R2073501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Scott Szymczak, DO
• T S Watson DC PA
• T. McNiff, M.D., PA
• Kenny Ta
• Xuanmai Thi Ta, O.D.
• Jordan Tabbakh, MD, MS
• Kathleen M Taber, M.ED., ATC
• Lesley Erin Taber, PA-C
• Alexis M Tackmann, RD
• Tactile Systems Technology, Inc

• Registered Nurse in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.