Dendekker, Tara

Dendekker, Tara is an sole proprietor health care provider with primary practice located at 4129 Okemos Rd Ste 6, Okemos MI 48864-2822. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dendekker, Tara can be contacted via phone (517) 803-4544.

Contact Information

Primary practice address
4129 Okemos Rd Ste 6 Okemos MI 48864-2822
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704301947 Michigan

Profile Details

NPI number 1073936688
LBN Legal business name Dendekker, Tara
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 3rd, 2014
Last updated Feb 3rd, 2014 - about 12 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 1073936688 NPPES
Michigan Other TD301947 BCBSM
Michigan Other 4704301947 BCBSM

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