TYNISE LA'SHAIE PENN (NPI# 1073841011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073841011 |
| Entity Type | Individual |
| Full Name | TYNISE LA'SHAIE PENN |
| Other Name | TYNISE LA'SHAIE GRAY |
| Credential | N.P. |
| Practice Address |
1985 Gratiot Blvd Suite 2a Marysville MI 48040-2215 |
| Mailing Address |
Po Box 1239 Troy MI 48099-1239 |
| Practice Telephone | 8103645050 |
| Practice Fax Number | 8103645688 |
| Mailing Telephone | 2488246558 |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2015-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704240129 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704240129 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1985 GRATIOT BLVD SUITE 2A |
| City | MARYSVILLE |
| State | MI |
| Zip Code | 48040-2215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740275981 | James Sterling Cabeen | Family Medicine | 1985 Gratiot Blvd, Ste 2a, Marysville, MI 48040-2215 | 2005-09-14 |
| 1861002131 | Port Huron Bone and Joint Surgery PC | Orthopaedic Surgery | 1985 Gratiot Blvd, Marysville, MI 48040-2215 | 2020-08-03 |
| 1972899680 | Arunthathi Tabitha Stallwood | Internal Medicine | 1985 Gratiot Blvd, Marysville, MI 48040-2215 | 2011-06-21 |
| 1497065635 | Laural K Wagley | Nurse Practitioner | 1985 Gratiot Blvd, Marysville, MI 48040-2215 | 2010-10-20 |
| 1295910651 | Derik Scott Evenson | Nurse Practitioner | 1985 Gratiot Blvd, Marysville, MI 48040-2215 | 2008-01-04 |
| 1023297967 | Rigel Galera | Family Medicine | 1985 Gratiot Blvd, Suite 2a, Marysville, MI 48040-2215 | 2007-10-28 |
| 1184702375 | Florello Itchon | Family Medicine | 1985 Gratiot Blvd, Suite 2a, Marysville, MI 48040-2215 | 2006-11-02 |
| 1518917491 | Amgad Nashed-awad | Family Medicine | 1985 Gratiot Blvd, Suite 2a, Marysville, MI 48040-2215 | 2006-05-11 |
| 1790750685 | Mary Cracium | Family Medicine | 1985 Gratiot Blvd, Suite 2a, Marysville, MI 48040-2215 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902106032 | Sheila Washington | Technician | 1600 Gratiot, Marysville, MI 48040 | 2010-10-22 |
| 1861522666 | Kriste Charlene Hollenbaugh | Pharmacist | 1750 Gratiot Blvd, Marysville, MI 48040 | 2007-03-07 |
| 1083760169 | Patrick August Deview | Optometrist | 3160 Gratiot, Marysville, MI 48040 | 2007-01-25 |
| 1346305133 | Meijer Inc | Durable Medical Equipment & Medical Supplies | 205 S Range Rd, Marysville, MI 48040 | 2006-12-22 |
| 1225143514 | City of Marysville | Ambulance | 1355 Delaware Avenue, Marysville, MI 48040 | 2006-08-20 |
| 1033603063 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 205 S Range Rd, Marysville, MI 48040 | 2018-06-22 |
| 1154449635 | Brenda Carolyn Hayden | Pharmacist | 1750 Gratiot Blvd, Marysville, MI 48040 | 2007-03-26 |
| 1235696956 | Lisa Curtis | Licensed Practical Nurse | 35 Carolina, Marysville, MI 48040-1011 | 2019-02-28 |
| 1447268529 | Karlene S. Harbour | Social Worker | 501 Gratiot Blvd, Suite 4, Marysville, MI 48040-1124 | 2006-08-04 |
| 1316020688 | Ks Harbour Consulting | Community/Behavioral Health | 501 Gratiot Blvd, Suite 4, Marysville, MI 48040-1124 | 2006-10-23 |
| Find all providers in zip 48040 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114038320 | Fonda Kay Shaw | Nurse Practitioner | 1908 N Beale Rd, Ste. E, Marysville, CA 95901-6937 | 2006-08-31 |
| 1437774338 | Jacqueline Wahl | Nurse Practitioner | 2901 174th St Ne, Marysville, WA 98271-4743 | 2020-06-16 |
| 1770133472 | Amber Elizabeth Thomas | Nurse Practitioner | 211 Broad St, Marysville, PA 17053-1302 | 2019-09-14 |
| 1740732452 | Kaitlyn Herr | Nurse Practitioner | 211 Broad St, Marysville, PA 17053-1302 | 2016-10-28 |
| 1407226681 | Jenny Johnston Coleman | Nurse Practitioner | 2901 174th St Ne, Marysville, WA 98271-4743 | 2015-10-01 |
| 1083055602 | Betsy L.e. Shaffer | Nurse Practitioner | 112 Morey Dr, Marysville, OH 43040-1646 | 2013-07-11 |
| 1790912384 | Teresa A Carter | Nurse Practitioner | 414 G St, Suite 208, Marysville, CA 95901-5663 | 2009-06-22 |
| 1558506261 | Spirit Physician Services, Inc. | Nurse Practitioner | 211 Broad St, Marysville, PA 17053-1302 | 2008-12-09 |
| 1205080454 | June A Hinkle | Nurse Practitioner | 660 London Ave, Marysville, OH 43040-1515 | 2008-11-13 |
| 1043495021 | Jennifer Ann Duncan | Nurse Practitioner | 414 G St, Suite 208, Marysville, CA 95901-5663 | 2008-01-08 |
| Find all providers in MARYSVILLE | ||||
| City | MARYSVILLE |
| Zip Code | 48040 |
Please comment or provide details below to improve the information on TYNISE LA'SHAIE PENN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.