Provider Demographics
NPI:1093514341
Name:POITRA, TAMMY J
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:J
Last Name:POITRA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3347 BIA ROAD 8
Mailing Address - Street 2:
Mailing Address - City:DUNSEITH
Mailing Address - State:ND
Mailing Address - Zip Code:58329-9300
Mailing Address - Country:US
Mailing Address - Phone:701-389-1258
Mailing Address - Fax:
Practice Address - Street 1:314 1ST ST. NE
Practice Address - Street 2:
Practice Address - City:DUNSEITH
Practice Address - State:ND
Practice Address - Zip Code:58329-5832
Practice Address - Country:US
Practice Address - Phone:701-244-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No253Z00000XAgenciesIn Home Supportive Care