Healthcare Provider Details

I. General information

NPI: 1679494249
Provider Name (Legal Business Name): TINA M GARRISON PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TINA M CRIPPEN

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29577 4TH ST
MILLSBORO DE
19966-4206
US

IV. Provider business mailing address

29577 4TH ST
MILLSBORO DE
19966-4206
US

V. Phone/Fax

Practice location:
  • Phone: 443-366-8098
  • Fax:
Mailing address:
  • Phone: 443-366-8098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0011191
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: