MEDICARE: TINA MICHELLE WESTMORELAND RN CNOR RNFA

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
1	163WR0006X	Registered Nurse First Assistant	523559	TX

General Provider Information

NPI Number	:	1518121078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA MICHELLE WESTMORELAND RN CNOR RNFA

Provider Business Mailing Address
First Line	:	PO BOX 670039
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75367-0039
Country	:	US
Telephone Number	:	214-378-9898
Fax Number	:	214-378-9888

Provider Business Practice Location Address
First Line	:	10830 N CENTRAL EXPY
Second Line	:	SUITE 120
City	:	DALLAS
State	:	TX
Zip	:	75231-1050
Country	:	US
Telephone Number	:	214-378-9898
Fax Number	:	214-378-9888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	08/10/2009

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