Provider Demographics
NPI:1447998224
Name:HOSFORD, TESSA (RN)
Entity type:Individual
Prefix:MS
First Name:TESSA
Middle Name:
Last Name:HOSFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 E JOLLY RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-6821
Mailing Address - Country:US
Mailing Address - Phone:517-346-8200
Mailing Address - Fax:
Practice Address - Street 1:812 E JOLLY RD STE 210
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-6821
Practice Address - Country:US
Practice Address - Phone:517-346-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704385374163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse