TANYA J BLACK APRN, BC
NPI 1770680894
Nurse Practitioner - Family in St Cloud, MN

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

Active since September 20, 2006

4801 VETERANS DR, ST CLOUD VAHCS, ST CLOUD, MN 56303(320) 252-1670 Get Directions Write a Review

NPPES record last updated: January 26, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Tanya J Black Aprn, Bc NPPES

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

TANYA J BLACK APRN, BC (NPI 1770680894) is an individual family provider in St Cloud, Minnesota, licensed in Minnesota (2006005172) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1770680894

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTANYA J BLACKCredential: APRN, BC

Location Address4801 VETERANS DR, ST CLOUD VAHCSSt Cloud, MN 56303

Mailing Address4801 Veterans Dr, St Cloud VahcsSt Cloud, MN 56303 · (320) 252-1670

Phone(320) 252-1670

Sole ProprietorNo

Enumeration DateSeptember 20, 2006

Last NPPES UpdateJanuary 26, 2016

✔ NPI 1770680894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MN · 2006005172

4801 VETERANS DR, St Cloud, MN 56303

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Other Identifiers 3

Medicaid71612000MN

Medicare PIN500003577MN

Medicare UPINQ72789MN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE P PITTMAN-LEYENDECKER CNP

Nurse Practitioner (Women's Health)