Provider Demographics
NPI:1043536220
Name:ALSEPT, TINA MARIE (CNP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:ALSEPT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2073
Mailing Address - Country:US
Mailing Address - Phone:330-364-2311
Mailing Address - Fax:330-364-7802
Practice Address - Street 1:300 MEDICAL PARK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2073
Practice Address - Country:US
Practice Address - Phone:330-364-2311
Practice Address - Fax:330-364-7802
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10706-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily