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General NPI Number Information
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NPI Number | 1831126192
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Entity Type | Individual
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Provider Name | TONYA HARBISON CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 15101 FORD RD
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City | DEARBORN
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State | MI
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Zip | 48126-4611
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Country | US
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Telephone | 313-582-2769
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Fax | 313-846-7708
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Provider Business Mailing Address
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Address Line | 701 MAIDEN CHOICE LN
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City | CATONSVILLE
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State | MD
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Zip | 21228-5968
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Country | US
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Telephone | 313-582-2769
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Fax | 313-846-7708
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4704101776
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License Number State | MI
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