MEDICARE: DR. TINA M DALRYMPLE PHD, APRN, F.N.P.

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	363LC1500X	Community Health Nurse Practitioner	F320046	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770538142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA M DALRYMPLE PHD, APRN, F.N.P.

Provider Business Mailing Address
First Line	:	1 ATWELL RD
Second Line	:
City	:	COOPERSTOWN
State	:	NY
Zip	:	13326-1301
Country	:	US
Telephone Number	:	607-263-2619
Fax Number	:	607-263-9629

Provider Business Practice Location Address
First Line	:	65 MAIN ST
Second Line	:
City	:	MORRIS
State	:	NY
Zip	:	13808
Country	:	US
Telephone Number	:	607-263-2619
Fax Number	:	607-263-9629

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	09/03/2013

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