Peterson, Tammy Hartnett
Peterson, Tammy Hartnett is an individual health care provider with primary practice located at 9055 Springbrook Dr Nw , Coon Rapids MN 55433-5841. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Peterson, Tammy Hartnett can be contacted via phone (763) 780-9155.Contact Information
Primary practice address
9055 Springbrook Dr Nw
Coon Rapids MN 55433-5841
Phone: (763) 780-9155
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1959 | Minnesota |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1961-035 | Wisconsin |
Profile Details
| NPI number | 1366404386 |
|---|---|
| LBN Legal business name | Peterson, Tammy Hartnett |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Oct 19th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366404386 | NPPES |
| Minnesota | MEDICAID | 168223700 |
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