Provider Demographics
NPI:1760111884
Name:TUNKARA, TIJANI (SRNA)
Entity type:Individual
Prefix:
First Name:TIJANI
Middle Name:
Last Name:TUNKARA
Suffix:
Gender:M
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 F J MCCREE DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-1691
Mailing Address - Country:US
Mailing Address - Phone:614-382-9148
Mailing Address - Fax:
Practice Address - Street 1:1105 F J MCCREE DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-1691
Practice Address - Country:US
Practice Address - Phone:614-382-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.0021139367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered