Tommie A Delap, LPN
Individual provider Active NPI Licensed Practical Nurse · Custer, MI
NPI 1972741973 · NPPES record last updated Jan 29, 2009
Key facts
- NPI
- 1972741973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 4703095848 (MI)
- Practice address
- 2171 N Reek Rd
Custer, MI 49405-9772 - Phone
- (231) 757-9197
- NPI assigned
- Jan 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4703095848 | MI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703095848 | MI | Yes |
Addresses
Primary practice location
2171 N Reek Rd
Custer, MI 49405-9772
Mailing address
2171 N Reek Rd
Custer, MI 49405-9772
Phone (231) 757-9197
Other providers in Custer, MI
All providers in Custer, MI · Licensed Practical Nurse in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2009. 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.