Individual
LORRAINE MARIE TANGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
AMG -ESTHERVILLE 926 N 8TH ST, ESTHERVILLE, IA 51334
(712) 362-6501
(712) 362-7190
Mailing address
AMG -ESTHERVILLE 926 N 8TH ST, ESTHERVILLE, IA 51334
(712) 362-6501
(712) 362-7190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-50220
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010002487
BLUE SHIELD OF IDAHO
ID
05
—
003978700
—
ID
01
—
1129286
STATE INSURANCE FUND
ID
01
—
820227163G0020
TRICARE
ID
01
—
DP070
BLUE CROSS OF IDAHO
ID
Enumeration date
02/18/2007
Last updated
01/11/2024
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