Provider Demographics
NPI:1174189211
Name:RADERMACHER, TAMMIE (LPN/HOUSING MANAGER)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:RADERMACHER
Suffix:
Gender:F
Credentials:LPN/HOUSING MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 GARFIELD AVE SE
Mailing Address - Street 2:
Mailing Address - City:FERTILE
Mailing Address - State:MN
Mailing Address - Zip Code:56540-4136
Mailing Address - Country:US
Mailing Address - Phone:218-945-6197
Mailing Address - Fax:218-945-6196
Practice Address - Street 1:300 GARFIELD AVE SE
Practice Address - Street 2:
Practice Address - City:FERTILE
Practice Address - State:MN
Practice Address - Zip Code:56540-4136
Practice Address - Country:US
Practice Address - Phone:218-945-6197
Practice Address - Fax:218-945-6196
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide