Individual
NAOMI P. TETZLAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8611 W POINT DOUGLAS RD S, COTTAGE GROVE, MN 55016-4005
(651) 458-1884
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-4813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39879
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
937317900
—
MN
Enumeration date
03/16/2006
Last updated
03/11/2021
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