Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704209974 | MN |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 4704209974 | MI |
NPI | 1265820468 |
---|---|
Provider Name | Sheri Lee Tomajko |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2014 |
Last Update Date | 11/02/2015 |