=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730245168
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NORMA LINDA TUMBUSCH RNC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 910 B SOUTH GRANT
-----------------------------------------------------
City | ODESSA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79761-6316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 432-580-9855
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9301 W COUNTY ROAD 162
-----------------------------------------------------
City | MIDLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79706-6046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 432-563-4519
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 249950
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------