Provider Demographics
NPI:1376277855
Name:VARNEY, TINA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:VARNEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:619 CHATAM CIR
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-9408
Mailing Address - Country:US
Mailing Address - Phone:517-425-1696
Mailing Address - Fax:
Practice Address - Street 1:216 OLDS ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:MI
Practice Address - Zip Code:49250-1128
Practice Address - Country:US
Practice Address - Phone:517-849-7100
Practice Address - Fax:517-849-2453
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704160630363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily