Mrs Tia Michelle Gullickson, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Red Lake Falls, Minnesota. She graduated from nursing school in 2015 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Riverview Healthcare Association and her current practice location is
105 International Dr, Ste. 126, Red Lake Falls, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 253-4606.
Mrs Tia Michelle Gullickson is licensed to practice in Minnesota (license number CNP 3937) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1992187868.
Provider's Profile
| Full Name | Mrs Tia Michelle Gullickson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 10 Years |
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| Location | 105 International Dr, Red Lake Falls, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Tia Michelle Gullickson graduated from nursing school in 2015
NPI Data:
- NPI Number: 1992187868
- Provider Enumeration Date: 06/26/2015
- Last Update Date: 06/26/2015
Medicare PECOS Information:
- PECOS PAC ID: 0749593804
- Enrollment ID: I20150717001787
Medical Identifiers
Medical identifiers for Mrs Tia Michelle Gullickson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1992187868 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | CNP 3937 (Minnesota) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Riverview Healthcare Association | 7810806718 | 42 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Tia Michelle Gullickson allows following entities to bill medicare on her behalf.
| Entity Name | Riverview Healthcare Association |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811918436
PECOS PAC ID: 7810806718
Enrollment ID: O20040128000040 |
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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. Mrs Tia Michelle Gullickson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Tia Michelle Gullickson, FNP-C
105 International Dr, Ste. 126,
Red Lake Falls, MN 56750-4665
Ph: (218) 253-4606 | Mrs Tia Michelle Gullickson, FNP-C
105 International Dr, Ste. 126,
Red Lake Falls, MN 56750-4665
Ph: (218) 253-4606 |
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