Individual
MICHELLE LAUREN TIERNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-2920
Mailing address
6000 BUCKHORN LAKE RD, HIGHLAND, MI 48357-2314
(248) 660-3563
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11712
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2021
Last updated
05/11/2026
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