Provider Demographics
NPI:1346635463
Name:PEER, TINA M (NP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:PEER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:704 2ND AVE N
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5746
Mailing Address - Country:US
Mailing Address - Phone:208-207-9422
Mailing Address - Fax:208-269-5828
Practice Address - Street 1:704 2ND AVE N STE 302
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5746
Practice Address - Country:US
Practice Address - Phone:208-207-9422
Practice Address - Fax:208-269-5828
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDNP1540A363L00000X
IDNP-1540A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner