Individual
TINA R THROOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
812 BRADLEY ST, OWOSSO, MI 48867-2552
(989) 729-4220
(989) 729-4230
Mailing address
633 APPLEGATE LN, GRAND BLANC, MI 48439-1668
(810) 407-0999
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
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