Provider Demographics
NPI:1558303230
Name:PARKER, TAMI K (PT)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:K
Last Name:PARKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 S COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4039
Mailing Address - Country:US
Mailing Address - Phone:701-746-8374
Mailing Address - Fax:218-683-2595
Practice Address - Street 1:218 3RD ST NE
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:ND
Practice Address - Zip Code:58257-1215
Practice Address - Country:US
Practice Address - Phone:218-686-5479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6849225100000X
ND1555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN20648OtherNDBS #
MN43G35PAOtherMNBS #
MN1344509OtherAMERICA'S PPO/ARAZ #
MN6401967OtherMEDICA #
MNDA9021015523OtherPREFERRED ONE #
MNHP38644OtherHEALTHPARTNERS #
MNP37495Medicare UPIN