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Tanner J. Nissly, DO
Family Medicine Physician in Minneapolis, Minnesota
NPI 1518131093

Tanner J. Nissly is a Family Medicine Physician based in Minneapolis, MN. Tanner J. Nissly practices in Minneapolis, MN and has the professional credentials of DO. The NPI Number for Tanner J. Nissly is 1518131093 and holds a License No. (Minnesota).

The current practice location address for Tanner J. Nissly is 1020 W Broadway Ave, Minneapolis, MN and can be reached out via phone at 612-302-8209.

Location: 1020 W Broadway Ave, Minneapolis, MN, 55411-2504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518131093
Provider Name
Tanner J. Nissly
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1020 W Broadway Ave, Minneapolis, MN, 55411-2504
Phone Number
612-302-8209
Fax Number
Provider Enumeration Date
04/16/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1020 W Broadway Ave
City
Minneapolis
State
Minnesota
Zip
55411-2504
Phone Number
612-302-8209
Fax Number
person
Provider Business Mailing Address Details
Address
1020 W Broadway Ave
City
Minneapolis
State
Minnesota
Zip
55411-2504
Phone Number
612-302-8209
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
50925 (Minnesota)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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