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NPI Code Detail

MEDICARE: TAMMY SUE GUSTAFSON

MEDICARE:   TAMMY SUE GUSTAFSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WH0200XHome Health Registered Nurse4704265274MI

General Provider Information

NPI Number : 1841169737
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY SUE GUSTAFSON
Provider Business Mailing Address
First Line : N9238 NORWAY LAKE RD
Second Line :
City : FELCH
State : MI
Zip : 49831-8854
Country : US
Telephone Number : 906-282-9502
Fax Number :
Provider Business Practice Location Address
First Line : 325 E H ST
Second Line :
City : IRON MOUNTAIN
State : MI
Zip : 49801-4760
Country : US
Telephone Number : 906-282-9502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2025
Last Update Date : 03/27/2026

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Directions to “ TAMMY SUE GUSTAFSON ” Practice Location

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