Provider Demographics
NPI:1003070137
Name:TINSON, FAYE DARBY (CNP)
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:DARBY
Last Name:TINSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:FAYE
Other - Middle Name:ANN
Other - Last Name:TINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:1720 S GADSDEN ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-5506
Mailing Address - Country:US
Mailing Address - Phone:850-980-8676
Mailing Address - Fax:850-576-4073
Practice Address - Street 1:1720 S GADSDEN ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-5506
Practice Address - Country:US
Practice Address - Phone:850-576-4073
Practice Address - Fax:850-576-4073
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR65144363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002179800Medicaid
FLARNP2150082OtherSTATE LICENSE