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General NPI Number Information
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NPI Number | 1750181889
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Entity Type | Individual
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Provider Name | CHANCE STEWART TINER NP
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Gender | Male
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 865 S 1ST ST
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City | JESUP
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State | GA
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Zip | 31545-0210
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Country | US
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Telephone | 912-816-3230
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Fax |
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Provider Business Mailing Address
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Address Line | 2570 GA HIGHWAY 32 E
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City | MERSHON
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State | GA
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Zip | 31551-2054
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Country | US
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Telephone | 912-281-9148
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN294402
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN294402
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License Number State | GA
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