Healthcare Provider Details

I. General information

NPI: 1598405888
Provider Name (Legal Business Name): KRYSTAL ELIZABETH TINNEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 08/06/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEMORIAL AVE
WESTMINSTER MD
21157-5726
US

IV. Provider business mailing address

122 KELHIGH DR
CHAMBERSBURG PA
17201-8004
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-3000
  • Fax:
Mailing address:
  • Phone: 210-844-5483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0104459
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: