| Tynise La'shaie Penn, NP | |
|
29877 Telegraph Rd Ste 401, Southfield, MI 48034-7661 | |
| (248) 294-0539 | |
| (248) 934-1390 |
| Full Name | Tynise La'shaie Penn |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 29877 Telegraph Rd Ste 401, Southfield, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073841011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | 4704240129 (Michigan) | Secondary |
| 363L00000X | Nurse Practitioner | 4704240129 (Michigan) | Primary |
| Entity Name | Commerce Sports And Spine Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720629157 PECOS PAC ID: 3870926397 Enrollment ID: O20191213000826 |
| Entity Name | Signify Health Medical Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20210405000855 |
| Mailing Address | Practice Location Address |
|---|---|
| Tynise La'shaie Penn, NP 31355 Bretz Dr, Warren, MI 48093-5532 Ph: (313) 350-1657 | Tynise La'shaie Penn, NP 29877 Telegraph Rd Ste 401, Southfield, MI 48034-7661 Ph: (248) 294-0539 |
Mrs. Theonna Monique Hindmon-harris, NURSE PRACTITIONER Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 21700 Northwestern Hwy Ste 815, Southfield, MI 48075 Phone: 248-557-3337 Fax: 248-557-3339 | |
Charmaine Adegeye, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 25240 Lahser Rd Ste 2, Southfield, MI 48033 Phone: 248-564-1367 Fax: 734-725-6746 | |
Ms. Jessica L Beacome, ACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16001 W 9 Mile Rd, 101 Fischer Center, Southfield, MI 48075 Phone: 248-849-8716 Fax: 248-849-2565 | |
Teresea Ann Zarza, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16001 W 9 Mile Rd, Southfield, MI 48075 Phone: 248-849-2528 Fax: 248-849-8256 | |
Nicole Noel Silvestri, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16001 W 9 Mile Rd, Southfield, MI 48075 Phone: 248-849-5806 Fax: 248-849-5489 | |
Mrs. Caroline B Trapp, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 29201 Telegraph Rd, Suite 404, Southfield, MI 48034 Phone: 248-355-0880 Fax: 248-355-9232 | |
Mrs. Bernadette Ann Bruno, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16001 W 9 Mile Rd, Southfield, MI 48075 Phone: 248-849-2536 |