1437280690 NPI number — TAMARA RAE NORLING PA-C

Table of content: TAMARA RAE NORLING PA-C (NPI 1437280690)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437280690 NPI number — TAMARA RAE NORLING PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NORLING
Provider First Name:
TAMARA
Provider Middle Name:
RAE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BERG
Provider Other First Name:
TAMARA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437280690
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
66111 182ND PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACOBSON
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-444-3596
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WAPITI MEDICAL STAFFING
Provider Second Line Business Practice Location Address:
912 INDUSTRIAL DRIVE, SUITE 102
Provider Business Practice Location Address City Name:
MILBANK
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-438-6918
Provider Business Practice Location Address Fax Number:
888-242-9992
Provider Enumeration Date:
03/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  1154 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 11867 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)