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Individual
MRS. TYANN R BILLMAN
Active
Individual
MRS. TYANN R BILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003977
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105519
NCCPA
MI
01
—
2467525361
US DEPT OF TRANSPORTATION
MI
05
—
34335
—
MI
01
—
5120031
BCBSM
MI
01
—
MI4324001
MEDICARE PTAN
MI
Enumeration date
05/11/2006
Last updated
11/13/2018
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