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General NPI Number Information
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NPI Number | 1790417624
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Entity Type | Individual
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Provider Name | CRYSTAL LEANN TINCH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 1018 HIGHWAY 321 N
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City | LENOIR CITY
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State | TN
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Zip | 37771-6683
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Country | US
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Telephone | 865-986-4450
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Fax | 833-908-2124
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Provider Business Mailing Address
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Address Line | PO BOX 26194
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City | BELFAST
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State | ME
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Zip | 04915-2012
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Country | US
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Telephone | 865-584-4747
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Fax | 865-584-4747
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 31892
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 31892
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License Number State | TN
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