Provider Demographics
NPI:1275615072
Name:BROCHMAN, TAMMI (RD, LD)
Entity type:Individual
Prefix:
First Name:TAMMI
Middle Name:
Last Name:BROCHMAN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:TAMMI
Other - Middle Name:
Other - Last Name:GOETZKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5100 190TH ST E
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-9373
Mailing Address - Country:US
Mailing Address - Phone:651-491-4574
Mailing Address - Fax:
Practice Address - Street 1:5100 190TH ST E
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-9373
Practice Address - Country:US
Practice Address - Phone:651-491-4574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2084133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered