Individual
TINA WALNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
50766 OAKS DR, CHESTERFIELD, MI 48047-4697
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704195155
MI
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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