Provider Demographics
NPI:1033362827
Name:ROPES, TANYA LYNN (NP-C)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:LYNN
Last Name:ROPES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21553 30 MILE RD
Mailing Address - Street 2:
Mailing Address - City:RAY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48096-1914
Mailing Address - Country:US
Mailing Address - Phone:586-201-0574
Mailing Address - Fax:586-749-7229
Practice Address - Street 1:15055 22 MILE RD STE 3
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-4401
Practice Address - Country:US
Practice Address - Phone:586-566-7100
Practice Address - Fax:586-566-8088
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704243889363LP2300X, 363LA2200X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0867447OtherBCBS PIN
MI500E012730OtherBCBS GROUP NUMBER
MI0867447OtherBCBS PIN
MI0N40180Medicare PIN