| Tara Haefner, | |
|
1835 County Road C W, Roseville, MN 55113-1352 | |
| (651) 638-9981 | |
| Not Available |
| Full Name | Tara Haefner |
|---|---|
| Gender | Female |
| Speciality | Audiologist |
| Location | 1835 County Road C W, Roseville, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649630013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | 9444 (Minnesota) | Primary |
| Provider Name | Audiology Distribution LLC |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1164707998 PECOS PAC ID: 0840459103 Enrollment ID: O20241121002140 |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Haefner, 1835 County Road C W, Roseville, MN 55113-1352 Ph: Not Available | Tara Haefner, 1835 County Road C W, Roseville, MN 55113-1352 Ph: (651) 638-9981 |
Ms. Laura Anne Morrison, AUD CCCA Audiologist Medicare: Medicare Enrolled Practice Location: 1745 Lexington Ave N, Roseville, MN 55113 Phone: 651-646-9200 Fax: 651-646-8111 |
Tara Wingate, AUD Audiologist Medicare: Medicare Enrolled Practice Location: 2345 Fairview Ave N, Roseville, MN 55113 Phone: 651-633-4642 |
Active Hearing And Audiology Audiologist Medicare: Not Enrolled in Medicare Practice Location: 2680 Snelling Ave N, #265, Roseville, MN 55113 Phone: 651-600-3245 Fax: 651-600-3182 |