MEDICARE: DINA KHENTIGAN DNP, RN, C-EFM, ACE-

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	163W00000X	Registered Nurse	RN9651696	FL

General Provider Information

NPI Number	:	1871440743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINA KHENTIGAN DNP, RN, C-EFM, ACE-

Provider Business Mailing Address
First Line	:	205 GNARLED OAKS DR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-4205
Country	:	US
Telephone Number	:	704-258-0603
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 GNARLED OAKS DR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-4205
Country	:	US
Telephone Number	:	704-258-0603
Fax Number	:

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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