Most Relevant Information
Provider Data
| NPI Number: | 1003541707 |
| Provider Name: | MICKIE TINGLEY RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 4704225660 |
Most Important Dates
| Enumeration Date: | 07/18/2022 |
| Last Updated: | 07/18/2022 |
Provider Practice Location
7014 DEWEESE RD
JACKSON
MI
492017515
Practice Location Phone/Fax
| Phone: | 2697166970 |
| Fax: |
Provider Mailing Location
890 N 10TH ST
KALAMAZOO
MI
490096192
Provider Mailing Phone/Fax
| Phone: | 2694278400 |
| Fax: |