Healthcare Provider Details

I. General information

NPI: 1578975918
Provider Name (Legal Business Name): RESSIE STRANALY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7870W US HIGHWAY 2
MANISTIQUE MI
49854-1599
US

IV. Provider business mailing address

7870W US HIGHWAY 2
MANISTIQUE MI
49854-1599
US

V. Phone/Fax

Practice location:
  • Phone: 906-341-3200
  • Fax: 906-286-4126
Mailing address:
  • Phone: 906-341-3200
  • Fax: 906-286-4126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704304769
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: