Antenalu Desta Tona, is a
Nurse Practitioner - Psychiatric/mental Health based in Spring Lake Park, Minnesota. Antenalu Desta Tona is licensed to practice in Minnesota (license number 10993) and his current practice location is
8340 5th St Ne, Spring Lake Park, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(612) 886-5439.
NPI number for Antenalu Desta Tona is 1679348247 and his current mailing address is 8340 5th St Ne, Spring Lake Park, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679348247.
Provider's Profile
Full Name | Antenalu Desta Tona |
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Gender | Male |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 8340 5th St Ne, Spring Lake Park, Minnesota |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1679348247
- Provider Enumeration Date: 11/23/2023
- Last Update Date: 11/23/2023
Medical Identifiers
Medical identifiers for Antenalu Desta Tona such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679348247 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 10993 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Antenalu Desta Tona is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Antenalu Desta Tona, 8340 5th St Ne, Spring Lake Park, MN 55432-1135 Ph: (612) 886-5439 | Antenalu Desta Tona, 8340 5th St Ne, Spring Lake Park, MN 55432-1135 Ph: (612) 886-5439 |
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