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Individual

TAMMIE J. HARDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1380 S COLUMBIA RD, GRAND FORKS, ND 58201-4059
(701) 795-2000
(701) 780-4391
Mailing address
2401 DEMERS AVE -ALTRU BUSINESS CENTER, GRAND FORKS, ND 58201
(701) 780-1891
(701) 776-5448

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0031
ND
363L00000X
Nurse Practitioner
PAC0031
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18978
BCBSND
ND
05
71216
ND
01
N4691
BLUE SHIELD
ND
Enumeration date
09/20/2006
Last updated
10/13/2020
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