Individual
TAMI LYNN PETTENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1005 W GREEN ST, HASTINGS, MI 49058-1710
(269) 948-5892
Mailing address
100 MICHIGAN ST NE, # MC-845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704237433
MI
Other
Enumeration date
01/24/2017
Last updated
04/07/2025
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