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NPI Code Detail

MEDICARE: MRS. DOVIE NILE TINANA ARNP

MEDICARE: MRS. DOVIE NILE TINANA ARNP
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
1363LF0000XFamily Nurse PractitionerARNP2881362FL
2363L00000XNurse PractitionerAPRN2881362FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962889048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DOVIE NILE TINANA ARNP
Provider Business Mailing Address
First Line : 5284 CAMELOT FOREST DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32258-1533
Country : US
Telephone Number : 904-292-3986
Fax Number :
Provider Business Practice Location Address
First Line : 4475 SAN JUAN AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-3357
Country : US
Telephone Number : 904-389-0314
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2015
Last Update Date : 08/06/2019

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