Individual
MYRTH CRYSTAL CONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1500 SANDPOINT RD, MUNISING, MI 49862-1406
(906) 387-4110
(906) 387-2825
Mailing address
622W SUPERIOR ST, MUNISING, MI 49862-1329
(906) 387-4614
(906) 387-4727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704173840
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704173840
STATE LICENSE
MI
Enumeration date
02/24/2006
Last updated
11/12/2015
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