Basic Information
| Provider Information | |||||||||
| NPI: | 1407914625 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TVRDY | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | RANA | ||||||||
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| Credential: | OTDRL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14325 FAIRWAY DR | ||||||||
| Address2: | |||||||||
| City: | EDEN PRAIRIE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553441956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5625523250 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7570 MARKET PLACE DR | ||||||||
| Address2: | |||||||||
| City: | EDEN PRAIRIE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553443636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529440240 | ||||||||
| FaxNumber: | 9529440241 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 07/24/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 103355 | MN | Y | Other Service Providers | Specialist |
No ID Information.