Provider Demographics
NPI:1215988506
Name:TUNNEY, MICHAEL JOHN
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:TUNNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360001
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89036-8108
Mailing Address - Country:US
Mailing Address - Phone:702-636-3000
Mailing Address - Fax:
Practice Address - Street 1:1841 E CRAIG RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-3391
Practice Address - Country:US
Practice Address - Phone:702-636-3000
Practice Address - Fax:702-636-4057
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM50451835P0018X
NV112781835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist