Healthcare Provider Details

I. General information

NPI: 1538018932
Provider Name (Legal Business Name): TINA B. GULBRONSEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 W SHAW AVE
CLOVIS CA
93612-3685
US

IV. Provider business mailing address

3875 W BEECHWOOD AVE
FRESNO CA
93711-0795
US

V. Phone/Fax

Practice location:
  • Phone: 800-492-4227
  • Fax: 833-353-1562
Mailing address:
  • Phone: 800-492-4227
  • Fax: 833-353-1562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number603357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: