Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 4704186388 | MI |
NPI | 1275830812 |
---|---|
Provider Name | Mrs. Tania Lyn Newman |
First Address | Lasalle, ONTARIO N9J1W7 |
Second Address | Detroit, MI 48202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2011 |
Last Update Date | 17/02/2011 |