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NPI Code Detail

MEDICARE: ALLISON TINER APRN

MEDICARE:   ALLISON  TINER  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerA004690AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A004690OTHERARCERTIFIED NURSE PRACTITIONER LICENSE NUMBER

General Provider Information

NPI Number : 1285094052
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON TINER APRN
Provider Business Mailing Address
First Line : PO BOX 9662
Second Line :
City : CONWAY
State : AR
Zip : 72033-9662
Country : US
Telephone Number : 501-852-1363
Fax Number :
Provider Business Practice Location Address
First Line : 2526 HIGHWAY 65 S STE 203
Second Line :
City : CLINTON
State : AR
Zip : 72031-6678
Country : US
Telephone Number : 501-745-4914
Fax Number : 501-745-6374
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2016
Last Update Date : 11/09/2023

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Directions to “ ALLISON TINER APRN” Practice Location

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