Provider Demographics
NPI:1811390362
Name:FEJFAR, TAMMY LYNN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LYNN
Last Name:FEJFAR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MRS
Other - First Name:TAMARA
Other - Middle Name:LYNN
Other - Last Name:FEJFAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:860 MANKATO AVE
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-4867
Mailing Address - Country:US
Mailing Address - Phone:507-452-6308
Mailing Address - Fax:507-858-3236
Practice Address - Street 1:860 MANKATO AVE
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-4867
Practice Address - Country:US
Practice Address - Phone:507-452-6308
Practice Address - Fax:507-858-3236
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13909-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist