Healthcare Provider Details

I. General information

NPI: 1720257322
Provider Name (Legal Business Name): TNT NURSING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8695 GRAND KAL RD SW
FIFE LAKE MI
49633-9528
US

IV. Provider business mailing address

8695 GRAND KAL RD SW
FIFE LAKE MI
49633-9528
US

V. Phone/Fax

Practice location:
  • Phone: 231-879-4230
  • Fax: 231-879-4230
Mailing address:
  • Phone: 231-879-4230
  • Fax: 231-879-4230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number4703081487
License Number StateMI

VIII. Authorized Official

Name: THERESA L LAFATA-PROVOST
Title or Position: OWNER
Credential:
Phone: 231-879-4230