Individual
TONYA HARBISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
15101 FORD RD, DEARBORN, MI 48126-4611
(313) 582-2769
(313) 846-7708
Mailing address
701 MAIDEN CHOICE LN, CATONSVILLE, MD 21228-5968
(313) 582-2769
(313) 846-7708
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704101776
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831126192
—
MI
01
—
5008665410
BCBS OF MI
—
01
—
8304953
EVERCARE
—
Enumeration date
06/26/2006
Last updated
06/24/2009
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