Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tonya Marie Wall

Individual provider Nurse Practitioner · NPI 1487028379

Tonya Marie Wall is a Nurse Practitioner in Detroit, Michigan. Qualified in 2015, 11 years ago. Practices with Henry Ford Health System, a 2,540-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
11
Licensed in
MI
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone: (313) 916-9405
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 4704212472 (MI)
Nurse Practitioner Taxonomy 363L00000X · Licence 4704212472 (MI)

Record details

NPI number1487028379
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 16, 2015
Last updated in NPPESJanuary 10, 2023
Certification dateJanuary 10, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Henry Ford Health System — 2540 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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