Provider Demographics
NPI:1417543224
Name:TINSLEY, DEVIUNTE T
Entity Type:Individual
Prefix:
First Name:DEVIUNTE
Middle Name:T
Last Name:TINSLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 CANAL RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36605-9733
Mailing Address - Country:US
Mailing Address - Phone:251-721-7114
Mailing Address - Fax:
Practice Address - Street 1:1508 CANAL RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36605-9733
Practice Address - Country:US
Practice Address - Phone:251-721-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health