Healthcare Provider Details

I. General information

NPI: 1366684979
Provider Name (Legal Business Name): TINA RIGSBY PROUSALIS A.R.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 TALLEVAST RD. SUN HYDROLICS
SARASOTA FL
34243
US

IV. Provider business mailing address

4601 CHARLOTTE PARK DR STE 390
CHARLOTTE NC
28217-1900
US

V. Phone/Fax

Practice location:
  • Phone: 941-362-1300
  • Fax: 941-362-1349
Mailing address:
  • Phone: 704-529-6161
  • Fax: 704-831-6097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4009700
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2680462
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1183108
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: