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General NPI Number Information
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NPI Number | 1194115790
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Entity Type | Organization
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Legal Business Name | SYNERGY HEALTHCARE PLLC
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 12100 SINGLETREE LN STE 129
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-7937
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Country | US
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Telephone | 952-746-1256
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Fax | 952-746-1392
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Provider Business Mailing Address
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Address Line | 12100 SINGLETREE LN STE 129
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-7937
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Country | US
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Telephone | 952-746-1256
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Fax | 952-746-1392
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Authorized Official
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Title or Position | FAMILY NURSE PRACITITIONER
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Name | TONYA LYNN HAASE
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Credential | CNP
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Telephone | 612-916-0593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | R158646-8
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License Number State | MN
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