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NPI Code Detail

MEDICARE: MRS. TANJA REBEKKA KINNEY FNP-C

MEDICARE: MRS. TANJA REBEKKA KINNEY FNP-C
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
1363L00000XNurse PractitionerAPN.0993652.NPCO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10993652OTHERCOSTATE LICENSE

General Provider Information

NPI Number : 1942798947
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TANJA REBEKKA KINNEY FNP-C
Provider Business Mailing Address
First Line : 300 S NEVADA AVE
Second Line :
City : MONTROSE
State : CO
Zip : 81401-4273
Country : US
Telephone Number : 970-249-7751
Fax Number : 970-249-5029
Provider Business Practice Location Address
First Line : 569 32 RD STE 12
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81504-6095
Country : US
Telephone Number : 970-523-3544
Fax Number : 970-434-3422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2018
Last Update Date : 05/22/2019

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Directions to “ MRS. TANJA REBEKKA KINNEY FNP-C” Practice Location

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