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:
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Health care specialties

SpecialtyCodeLicense #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 15 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 1366404386 NPPES
Minnesota MEDICAID 168223700

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