Provider Demographics
NPI:1801397443
Name:NUNNARI, TANIA
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:NUNNARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-4860
Mailing Address - Country:US
Mailing Address - Phone:989-493-3423
Mailing Address - Fax:
Practice Address - Street 1:2394 MIDLAND RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-9402
Practice Address - Country:US
Practice Address - Phone:989-684-2303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502001843225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant