Healthcare Provider Details

I. General information

NPI: 1144390758
Provider Name (Legal Business Name): CINDY TIPPING NEARY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 REID ST MADIGAN ARMY MEDICAL CENTER
TACOMA WA
98431-1100
US

IV. Provider business mailing address

6338 SCHOOL ST SW
LAKEWOOD WA
98499-1319
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-4284
  • Fax: 253-968-4229
Mailing address:
  • Phone: 253-588-6090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberD6292704
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: