Individual
MS. TAMMY LYNN PROHOFSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
11000 OPTUM CIR, EDEN PRAIRIE, MN 55344-2503
(866) 686-2504
Mailing address
12490 FAIRBANKS AVE, LONSDALE, MN 55046-4475
(763) 257-9280
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7897
MN
363L00000X
Nurse Practitioner
R147035-4
MN
Other
Enumeration date
11/04/2020
Last updated
07/24/2024
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