Tamora Vanwasshnova, FNP
Individual provider Active NPI Family Nurse Practitioner · Marshall, MI
NPI 1568094340 · NPPES record last updated May 27, 2022
Key facts
- NPI
- 1568094340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704206479 (MI)
- Practice address
- 13697 15 Mile Rd
Marshall, MI 49068-8533 - Phone
- (269) 789-4905
- NPI assigned
- Feb 10, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704206479 | MI | Yes |
Addresses
Primary practice location
13697 15 Mile Rd
Marshall, MI 49068-8533
Mailing address
24 Frank Lloyd Wright Dr Lbby J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766
Other practice location 1
212 S Main St Ste A
Brooklyn, MI 49230-9114
Phone (517) 592-8033
Other providers in Marshall, MI
- Jose Manuel Valle
- Lynn M Van Gieson-Culver
- Craig M. Van Zyl
- Suzanne E Vandenbrink-Webb
- Douglas Alan Vandermeulen
- Amy Vanzandt
- Aric Vaughn
- Vincent Shen MD PLC
- Vituity-Michigan Health Services PC
- Cynthia A Wagner
All providers in Marshall, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.