Main, Tanetta C

Main, Tanetta C is an individual health care provider with primary practice located at 410 N 12Th St , Oskaloosa IA 52577-2495. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Main, Tanetta C can be contacted via phone (641) 672-3360.

Contact Information

Primary practice address
410 N 12Th St Oskaloosa IA 52577-2495
Phone: (641) 672-3360
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X A-112035 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2000167490 Missouri

Profile Details

NPI number 1770548075
LBN Legal business name Main, Tanetta C
Credentials RN, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Jun 19th, 2019 - about 5 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 1770548075 NPPES
Other 36800048 BCBS
MEDICAID 540568508 BCBS
MEDICAID 595956103 BCBS
MEDICAID 599225901 BCBS
MEDICAID 420721300 BCBS
MEDICAID 010568509 BCBS
Other 36800018 BCBS
MEDICAID 595956202 BCBS
MEDICAID 595956400 BCBS
MEDICAID 595985805 BCBS

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