Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 8129 | MN |
N | 363LP2300X | Nurse Practitioner - Primary Care | 4704282498 | MI |
NPI | 1043853625 |
---|---|
Provider Name | Ms. Christy Lee Tunney |
First Address | Eaton Rapids, MI 48827-8519 |
Second Address | Eaton Rapids, MI 48827-8519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2019 |
Last Update Date | 14/10/2021 |