Elgersma, Tammy S
Elgersma, Tammy S is an individual health care provider with primary practice located at 710 Riverside Dr , Waupaca WI 54981-1941. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Elgersma, Tammy S can be contacted via phone (715) 256-3000.Contact Information
Primary practice address
710 Riverside Dr
Waupaca WI 54981-1941
Phone: (715) 256-3000
Fax: (715) 256-3079
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2211-023 | Wisconsin |
Profile Details
| NPI number | 1710167671 |
|---|---|
| LBN Legal business name | Elgersma, Tammy S |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 8th, 2007 |
| Last updated | May 20th, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710167671 | NPPES |
| Wisconsin | MEDICAID | 1710167671 |
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