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General NPI Number Information
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NPI Number | 1245901701
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Entity Type | Individual
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Provider Name | JOHNNA DIANE TUNNYHILL NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/24/2021
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 19 LAKES AVENUE
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City | NESPELEM
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State | WA
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Zip | 99155
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Country | US
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Telephone | 509-634-2913
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 E 15TH AVE
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City | SPOKANE
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State | WA
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Zip | 99203-3502
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Country | US
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Telephone | 206-909-6559
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61176303
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License Number State | WA
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