Healthcare Provider Details

I. General information

NPI: 1295981470
Provider Name (Legal Business Name): DESHONDA SHONTA TYYNISMAA FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35522 REMINGTON DR
STERLING HEIGHTS MI
48310-4911
US

IV. Provider business mailing address

35522 REMINGTON DR
STERLING HEIGHTS MI
48310-4911
US

V. Phone/Fax

Practice location:
  • Phone: 586-232-9825
  • Fax: 586-204-0272
Mailing address:
  • Phone: 586-232-9825
  • Fax: 586-204-0272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704230317
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704230317
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: