Heinze, Tara A.

Heinze, Tara A. is an individual health care provider with primary practice located at 400 22Nd Ave. , Brookings SD 57006-2497. 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. Heinze, Tara A. can be contacted via phone (605) 697-9500.

Contact Information

Primary practice address
400 22Nd Ave. Brookings SD 57006-2497
Phone: (605) 697-9500
Fax: (605) 697-6939
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0561 South Dakota

Profile Details

NPI number 1053363242
LBN Legal business name Heinze, Tara A.
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Sep 24th, 2007 - about 19 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 1053363242 NPPES
South Dakota MEDICAID 6825452

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