Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | R65144 | NM |
NPI | 1003070137 |
---|---|
Provider Name | Faye Darby Tinson |
First Address | Tallahassee, FL 32301-5506 |
Second Address | Tallahassee, FL 32301-5506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2008 |
Last Update Date | 24/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002179800 | (05) | FL |
ARNP2150082 | STATE LICENSE (01) | FL |