Individual
TINA R THROOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704174012
MI
363LW0102X
Women's Health Nurse Practitioner
Primary
4704174012
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518079086
—
MI
Enumeration date
08/31/2006
Last updated
09/25/2019
Update your record
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