Provider Demographics
NPI:1497267587
Name:TINAPAY, JEOFFREY (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JEOFFREY
Middle Name:
Last Name:TINAPAY
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5785 S FORT APACHE RD # A-100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5659
Mailing Address - Country:US
Mailing Address - Phone:832-465-1521
Mailing Address - Fax:
Practice Address - Street 1:3041 E. FLAMINGO RD. #A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121
Practice Address - Country:US
Practice Address - Phone:702-436-0835
Practice Address - Fax:702-435-6212
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002868207RI0011X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF09171475OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
NVAPRN002868OtherNEVADA STATE BOARD OF NURSING APRN LICENSE
NVRN98122OtherNEVADA REGISTERED NURSE LICENSE