Tara Lynn Dommert-Harrison, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · Ellsworth Afb, SD
NPI 1326282138 · NPPES record last updated Nov 30, 2009
Key facts
- NPI
- 1326282138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 2900 Doolittle Dr
Ellsworth Afb, SD 57706-4821 - Phone
- (605) 385-3433
- NPI assigned
- Apr 23, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
2900 Doolittle Dr
Ellsworth Afb, SD 57706-4821
Mailing address
1317 Summerfield Dr
Rapid City, SD 57703-4709
Phone (813) 758-5469
Other names
- Ms. Tara Lynn Goss
Other providers in Ellsworth Afb, SD
- Kara Christensen
- Grace Coen
- Benjamin Don Coon
- Amy Costello
- Sable Darling
- Joshua R Duncan
- Kimberly C Easterling
- Brett Dennis Forman
- Elijah Fox
- Shelton John Fraser
All providers in Ellsworth Afb, SD · Independent Duty Medical Technicians in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.