Individual
TAMMY BEARCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.R.D.
Contact information
Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7492
(701) 774-7479
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7492
(701) 774-7479
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
342
MT
133V00000X
Registered Dietitian
Primary
406
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000298578
BLUE CROSS BLUE SHIELD
MT
01
—
13078
BLUE CROSS OF ND
ND
01
—
21320
BLUE CROSS BLUE SHIELD
ND
01
—
25590
BLUE CROSS BLUE SHIELD
ND
05
—
52930
—
ND
Enumeration date
10/12/2006
Last updated
07/08/2007
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