Doctor Name: | TAMARA RANAE LOSEE |
NPI Number: | 1770992034 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | R-173821-6 |
Business Practice Address: | 501 State St N Waseca, MN - 560932811 |
Business Phone Number: | 5078353110 |
Business Fax Number: | |
Mailing Address: | 501 State St N, WASECA |
State: | MN |
Postal Code: | 560932811 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/11/2014 |
NPI Last Update Date: | 09/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R-173821-6 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |