Provider Demographics
NPI:1073356499
Name:MOSIER, TAMMY (RN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:MOSIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60651 205TH AVE
Mailing Address - Street 2:
Mailing Address - City:DODGE CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55927-8004
Mailing Address - Country:US
Mailing Address - Phone:507-884-7019
Mailing Address - Fax:
Practice Address - Street 1:60651 205TH AVE
Practice Address - Street 2:
Practice Address - City:DODGE CENTER
Practice Address - State:MN
Practice Address - Zip Code:55927-8004
Practice Address - Country:US
Practice Address - Phone:507-884-7019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1901551163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health