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General NPI Number Information
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NPI Number | 1053430462
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Entity Type | Individual
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Provider Name | TANIKA M. PINN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 1114 W 7TH ST
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City | COLUMBIA
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State | TN
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Zip | 38401-1810
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Country | US
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Telephone | 931-388-9706
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Fax | 931-490-1062
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Provider Business Mailing Address
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Address Line | PO BOX 2278
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City | KINSTON
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State | NC
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Zip | 28502-2278
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Country | US
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Telephone | 252-522-9800
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Fax | 252-523-9790
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 43965
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2020-04516
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 43965
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License Number State | TN
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