| Doctor Name: | MRS. TINA M SIESEL |
| NPI Number: | 1053323436 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 4704204074 |
| Business Practice Address: | 550 Osborn Blvd, Superior Family Medical Suite 101 Sault Sainte Marie, MI - 497831822 |
| Business Phone Number: | 9066320370 |
| Business Fax Number: | |
| Mailing Address: | 550 Osborn Blvd, Suite 101 SAULT SAINTE MARIE |
| State: | MI |
| Postal Code: | 497831899 |
| Phone Number: | 9066320370 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2006 |
| NPI Last Update Date: | 12/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704204074 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |