Individual
TANYA ANN BANNERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, PMHNP-BC
Contact information
Practice address
3600 N SAGINAW RD, MIDLAND, MI 48640-2301
(989) 510-7626
(989) 486-1554
Mailing address
3600 N SAGINAW RD, MIDLAND, MI 48640-2301
(989) 488-0936
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704311189
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704311189
MI
Other
Enumeration date
05/19/2023
Last updated
11/07/2024
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