Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4704195274 | MI |
N | 363LA2100X | Nurse Practitioner - Acute Care | 4704195274 | MI |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 4704195274 | MI |
NPI | 1457682437 |
---|---|
Provider Name | Ms. Tonya Rhea Markland |
First Address | Rochester Hills, MI 48309-1555 |
Second Address | Warren, MI 48093-3472 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2010 |
Last Update Date | 03/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500F385850 | BCBS GROUP (01) | MI |