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Individual

MS. TANYA ELISE MUDRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.P.M., L.T.M., L.M.

Contact information

Practice address
50 W 2ND ST, ROOM 108, WINONA, MN 55987-3440
(507) 474-0233
Mailing address
PO BOX 596, HOUSTON, MN 55943-0596
(507) 896-4985

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
1016
MN
176B00000X
Midwife
15-049
WI

Other

Enumeration date
02/21/2007
Last updated
11/28/2007
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