Healthcare Provider Details

I. General information

NPI: 1619659323
Provider Name (Legal Business Name): ARNETTE TINEO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7701 MOURNING DOVE RD
RALEIGH NC
27615-5010
US

IV. Provider business mailing address

7800 FALLS OF NEUSE ROAD PO BOX 97576
RALEIGH NC
27615
US

V. Phone/Fax

Practice location:
  • Phone: 919-847-7769
  • Fax:
Mailing address:
  • Phone: 984-480-6535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number141347
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: