Cornelius, Tammy Rose

Cornelius, Tammy Rose is an individual health care provider with primary practice located at 3425 13Th St , Baker City OR 97814-1340. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Cornelius, Tammy Rose can be contacted via phone (541) 523-7400.

Contact Information

Primary practice address
3425 13Th St Baker City OR 97814-1340
Phone: (541) 523-7400
Fax: (541) 523-4927
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X 21-QMHA-R-1324 Oregon

Profile Details

NPI number 1073182192
LBN Legal business name Cornelius, Tammy Rose
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2021
Last updated Jul 13th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073182192 NPPES
Oregon Other 4617078 ODL
Oregon MEDICAID 500795152 ODL

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