| Doctor Name: | MYRTH CRYSTAL CONDON |
| NPI Number: | 1184690760 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 4704173840 |
| Business Practice Address: | 1500 Sandpoint Rd Munising, MI - 498621406 |
| Business Phone Number: | 9063874110 |
| Business Fax Number: | 9063872825 |
| Mailing Address: | 622w Superior St, MUNISING |
| State: | MI |
| Postal Code: | 498621329 |
| Phone Number: | 9063874614 |
| Fax Number: | 9063874727 |
| NPI Enumeration Date: | 02/24/2006 |
| NPI Last Update Date: | 11/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704173840 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |