Provider Demographics
NPI:1538323068
Name:TINSON, PAULETTE ANDREA (RN)
Entity Type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:ANDREA
Last Name:TINSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:PAULETTE
Other - Middle Name:ANDREA
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:25714 147 AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422
Mailing Address - Country:US
Mailing Address - Phone:718-341-4502
Mailing Address - Fax:
Practice Address - Street 1:25714 147TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-3317
Practice Address - Country:US
Practice Address - Phone:718-341-4502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY505003163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse