Provider Demographics
NPI:1457634834
Name:AMACHER, TINA (APN)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:
Last Name:AMACHER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:TINA
Other - Middle Name:A
Other - Last Name:PING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:590 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398
Mailing Address - Country:US
Mailing Address - Phone:931-307-8021
Mailing Address - Fax:
Practice Address - Street 1:590 CASCADE DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-4748
Practice Address - Country:US
Practice Address - Phone:931-307-8021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
103I503071Medicare PIN