Provider Demographics
NPI:1447021985
Name:TRANQUIL MINDS PSYCHIATRY
Entity type:Organization
Organization Name:TRANQUIL MINDS PSYCHIATRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:CHERIE
Authorized Official - Last Name:ALBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN - PMHNP
Authorized Official - Phone:218-394-2774
Mailing Address - Street 1:402 3RD ST E STE 12
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MN
Mailing Address - Zip Code:56510-1404
Mailing Address - Country:US
Mailing Address - Phone:218-394-2774
Mailing Address - Fax:218-394-2780
Practice Address - Street 1:402 3RD ST E STE 12
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MN
Practice Address - Zip Code:56510-1404
Practice Address - Country:US
Practice Address - Phone:218-394-2774
Practice Address - Fax:218-394-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1548909229OtherNPPES