Provider Demographics
NPI:1164975926
Name:MOURRA, TINA Z (NP)
Entity Type:Individual
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First Name:TINA
Middle Name:Z
Last Name:MOURRA
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Gender:F
Credentials:NP
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Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:HCR MANORCARE MEDICAL SERVICES OF FLORIDA LLC
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:800-427-1902
Mailing Address - Fax:419-531-2664
Practice Address - Street 1:885 MACBETH DR
Practice Address - Street 2:HEARTLAND CARE PARTNERS
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3332
Practice Address - Country:US
Practice Address - Phone:800-427-1902
Practice Address - Fax:419-531-2664
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
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Provider Licenses
StateLicense IDTaxonomies
PASP016304363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner