TONYA MARIE WALL NPI 1487028379

NPI Information

NPI: 1487028379
Provider Name: TONYA MARIE WALL
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
2799 W GRAND BLVD
DETROIT, MI
ZIP 48202
Phone: (313) 916-9405
Get Directions

Tonya Marie Wall is a primary care nurse practitioner in Detroit, MI with 9 years of experience. Tonya Marie Wall NPI is 1487028379. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2799 W GRAND BLVD
DETROIT, MI
ZIP 48202-608
Phone: (313) 916-9405

The NPI 1487028379 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/16/2015 and was last updated on 1/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		4704212472	MICHIGAN	No
2	363LP2300X	Nurse Practitioner	Primary Care	4704212472	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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