Individual
TATIYANA STANKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 982-4862
(269) 985-4523
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 982-4862
(269) 985-4523
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704250149
MI
363LF0000X
Family Nurse Practitioner
28155366A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IN
Enumeration date
08/14/2008
Last updated
10/20/2016
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