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NPI Code Detail

MEDICARE: DENISE I TINKER PA

MEDICARE: DENISE I TINKER PA
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
1363AM0700XMedical Physician Assistant829IA

General Provider Information

NPI Number : 1780689174
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE I TINKER PA
Provider Business Mailing Address
First Line : 1836 SOUTH AVE
Second Line :
City : LA CROSSE
State : WI
Zip : 54601-5429
Country : US
Telephone Number : 608-782-7300
Fax Number :
Provider Business Practice Location Address
First Line : 110 JEFFERSON ST
Second Line :
City : WEST UNION
State : IA
Zip : 52175-1022
Country : US
Telephone Number : 563-422-3817
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 07/08/2007

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Directions to “ DENISE I TINKER PA” Practice Location

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