Individual
MRS. CHRISTY MARIE THALLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN RN FNP
Contact information
Practice address
1200 N TELEGRAPH RD, BLDG. 32E, PONTIAC, MI 48341-1032
(734) 464-0887
(734) 402-0254
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 464-0887
(734) 402-0254
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704203244
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N82760002
MEDICARE
MI
01
—
0N82770003
MEDICARE
MI
01
—
500F318890
BCBS
MI
Enumeration date
02/21/2006
Last updated
09/17/2015
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