Individual
MS. TANYA J. MUNGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1235 N MULFORD RD, SUITE 222, ROCKFORD, IL 61107-3879
(815) 397-8400
(815) 229-0050
Mailing address
1235 MORTH ROAD, SUITE 222, ROCKFORD, IL 61107-3879
(815) 397-8400
(815) 229-0050
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041322477
IL
363L00000X
Nurse Practitioner
Primary
209007248
IL
363LF0000X
Family Nurse Practitioner
309003966
IL
Other
Enumeration date
11/17/2008
Last updated
07/19/2018
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