Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP2048432 | FL |
NPI | 1003823535 |
---|---|
Provider Name | Sara Tinsley |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-9416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 19/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
265989100 | (05) | FL |
Y5444 | BLUE CROSS BLUE SHIELD (01) | FL |