Healthcare Provider Details

I. General information

NPI: 1700019205
Provider Name (Legal Business Name): TONYA MCNEW REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 S INDUSTRIAL HWY STE 75
ANN ARBOR MI
48104-6796
US

IV. Provider business mailing address

1760 BROOKFIELD DR
ANN ARBOR MI
48103-6074
US

V. Phone/Fax

Practice location:
  • Phone: 734-477-7204
  • Fax: 734-998-2369
Mailing address:
  • Phone: 734-206-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number4704196279
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: