Healthcare Provider Details

I. General information

NPI: 1316005085
Provider Name (Legal Business Name): ELLA MAY A TARRIER R.N., C.P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 N HURON ST
YPSILANTI MI
48197-2607
US

IV. Provider business mailing address

5081 PRATT RD
ANN ARBOR MI
48103-1488
US

V. Phone/Fax

Practice location:
  • Phone: 734-484-3600
  • Fax: 734-484-3100
Mailing address:
  • Phone: 734-769-8693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number4704084136
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: