Individual
MRS. TAMMY LYNN WECKERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
811 FOURNIE ST, MIDLAND, MI 48640-5307
(989) 964-1078
Mailing address
811 FOURNIE ST, MIDLAND, MI 48640-5307
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704234470
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
104788
MI
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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