Individual
TAMMY SUE GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 282-9502
Mailing address
N9238 NORWAY LAKE RD, FELCH, MI 49831-8854
(906) 282-9502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704265274
MI
163WH0200X
Home Health Registered Nurse
Primary
4704265274
MI
Other
Enumeration date
10/30/2025
Last updated
03/27/2026
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