Provider Demographics
NPI:1174099238
Name:STEERE, TABITHA ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:ANN
Last Name:STEERE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:ANN
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:730 S RICH RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:MI
Mailing Address - Zip Code:48847-9759
Mailing Address - Country:US
Mailing Address - Phone:989-289-3374
Mailing Address - Fax:
Practice Address - Street 1:101 W TOWNSEND RD
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-9200
Practice Address - Country:US
Practice Address - Phone:989-403-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704267675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily