Debra Tastad, RN,CNS

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

R092231-1 Issued in MN

Practice address

49725 County 83
Staples, MN 56479-5280

Phone

(218) 894-1515

Fax

(218) 894-8767

NPI assigned

Jan 6, 2006

Last updated

Aug 14, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Joseph's Medical Center

  dba Essentia Health St. Joseph's-Pillager Clinic

  • Primary Care Clinic/Center
  • Pillager, MN
  • NPI 1891740957
  NPD (past)

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1740268994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "218-894-1515",
            "fax_number": "218-894-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASTAD",
        "first_name": "DEBRA",
        "name_prefix": "Mrs.",
        "credential": "RN,CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MN",
            "license": "R092231-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN LICENSE",
            "identifier": "R92231-1",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Cloud Hospital (CentraCare Kidney Program - Staples Dialysis)
• Staples Eye Clinic PSC
• Staples Smiles
• Wade T Swenson II, MD
• Kelly Rose Taffe, SLP
• Jon Frederic Theurer, DC
• Chad G Thiel, MD
• Kelly Ann Thompson
• Sean R Tingum, PHARMD
• Carol L Uhlman, MD

• Clinical Nurse Specialist in Staples, MN
• Providers in Staples, MN by specialty
• Clinical Nurse Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.