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TEQUILA BUCKHANON
NPI 1477170777
Home Health in Brooklyn Center, MN

Active since July 02, 2020
5701 SHINGLE CREEK PKWY STE 250H, BROOKLYN CENTER, MN 55430(612) 695-5614 Get Directions Write a Review

NPPES record last updated: July 2, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Tequila Buckhanon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TEQUILA BUCKHANON (NPI 1477170777) is an individual home health provider in Brooklyn Center, Minnesota, licensed in Minnesota (10827598) and active in the NPI registry since July 2020.

NPPES Registry Identity

NPI1477170777
Entity TypeIndividualFemale
Primary Taxonomy251E00000X
Provider Legal NameTEQUILA BUCKHANON
Location Address5701 SHINGLE CREEK PKWY STE 250HBrooklyn Center, MN 55430-2344
Mailing Address5701 Shingle Creek Pkwy Ste 250hBrooklyn Center, MN 55430-2344
Phone(612) 695-5614
Sole ProprietorYes
Enumeration DateJuly 2, 2020
NPPES CertifiedJuly 2, 2020
✔ NPI 1477170777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License✔ Licensed in MN · 10827598
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Also ListedNon-emergency Medical Transport (VAN)Taxonomy 343900000X
5701 SHINGLE CREEK PKWY STE 250H, Brooklyn Center, MN 55430
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tequila Buckhanon's NPI number?

The NPI number for Tequila Buckhanon is 1477170777. It was assigned to this individual provider in the NPPES registry on July 2, 2020.

Where is Tequila Buckhanon located?

Tequila Buckhanon practices at 5701 Shingle Creek Pkwy Ste 250H, Brooklyn Center, MN 55430. The listed phone number is (612) 695-5614.

What is Tequila Buckhanon's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

When was this NPI record last updated?

The NPPES record for Tequila Buckhanon was last updated on July 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.