Individual provider · Type 1 NPI

Tara Barrack, PA-C

Surgical Physician Assistant · Maple Grove, MN

NPI number 1104266865 Active

Practice location

9555 Upland Ln N
Maple Grove, MN 55369-4485

Call (952) 993-1440 Map

Other practice locations

  • 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 · (651) 968-5201
  • 8100 Northland Dr, Bloomington, MN 55431-4800 · (952) 831-8742

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed
Physician Assistant 363A00000X11382 (MN)

Surgical Physician Assistant: Definition to come...

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About NPI 1104266865

Tara Barrack, PA-C's National Provider Identifier is 1104266865, issued on Jun 26, 2013. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Maple Grove, MN. The record was last updated on Apr 14, 2020.