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NPI Code Detail

MEDICARE: ELLEN TINNEY

MEDICARE:   ELLEN  TINNEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1598062325
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN TINNEY
Provider Business Mailing Address
First Line : 6640 ABRUZZI DR
Second Line : UNIT 204
City : NORTH LAS VEGAS
State : NV
Zip : 89084-5438
Country : US
Telephone Number : 702-994-1940
Fax Number :
Provider Business Practice Location Address
First Line : 6640 ABRUZZI DR
Second Line : UNIT 204
City : NORTH LAS VEGAS
State : NV
Zip : 89084-5438
Country : US
Telephone Number : 702-994-1940
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2011
Last Update Date : 01/13/2015

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Directions to “ ELLEN TINNEY ” Practice Location

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