TYNISE LA'SHAIE PENN

SOUTHFIELD, MI
NPI1073841011
Former NameTYNISE LA'SHAIE GRAY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: MI  4704240129)
Additional Taxonomies363LA2200X Nurse Practitioner, Adult Health
(Licence: MI  4704240129)
Enumeration Date2009-12-03
Last Update Date2024-02-28
Business Address
TYNISE LA'SHAIE PENN N.P.
29877 TELEGRAPH RD STE 401
SOUTHFIELD, MI 48034-7661
Phone number: 248-294-0539
Mailing Address
TYNISE LA'SHAIE PENN N.P.
31355 BRETZ DR
WARREN, MI 48093-5532
Phone number: 313-350-1657