Provider Demographics
NPI:1033455514
Name:AARON, TAMMY DELORIS (RN)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:DELORIS
Last Name:AARON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MOUND ST
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-2446
Mailing Address - Country:US
Mailing Address - Phone:952-405-6634
Mailing Address - Fax:
Practice Address - Street 1:130 MOUND ST
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-2446
Practice Address - Country:US
Practice Address - Phone:952-405-6634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR186194-7163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation