IndividualActive
Tara Randolph, PNP
NPI 1760119622 · Pediatric Nurse Practitioner · Minnetonka, MN
Provider details
- NPI number
- 1760119622
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PNP
- Sex
- Female
- Sole proprietor
- No
- License
- 9228 (MN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17705 Hutchins Dr
Minnetonka, MN 55345-4145
Phone: (952) 401-8252
Fax: (952) 401-8286
Street-level locationGet directions
Mailing address
6100 W 101st St
Bloomington, MN 55438-1816
Registry dates
- Enumerated
- 2022-08-02
- Last updated
- 2022-08-02
- Certified
- 2022-07-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.