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Individual
MS. TINA MARIE LOGAN
Active
Individual
MS. TINA MARIE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FAMILY NURSE PRACTIT
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704290093
MI
363LF0000X
Family Nurse Practitioner
Primary
4704290093
MI
Other
Enumeration date
06/15/2011
Last updated
04/28/2026
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