Individual
LOUANNE MICHELLE DEAR-TACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
222 9TH AVE W, ALEXANDRIA, MN 56308-2221
(320) 763-3912
Mailing address
606 EDGEWATER DR, ALEXANDRIA, MN 56308-8630
(320) 846-0801
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
R-171099-1
MN
Other
Enumeration date
04/22/2008
Last updated
04/23/2008
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