MRS. Tywanna R Tanner, NURSE PRACTITIONER
NPI #1518438332 in Lincoln Park, Michigan
Provider Information
- NPI Number
- 1518438332
- Entity Type
- Individual
- Name
- MRS. Tywanna R Tanner, NURSE PRACTITIONER
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner
- Credential
- NURSE PRACTITIONER
- Enumeration Date
- Dec 6, 2018
- Last Updated
- Sep 1, 2021
Practice Location
- Address
- 1158 FORT ST
- City
- Lincoln Park
- State
- Michigan
- ZIP Code
- 48146-1840
- Phone
- (313) 989-0124
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Pain — Pain |
| Nurse Practitioner |
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