Provider Demographics
NPI:1578833828
Name:TINSLEY, ELLEN ELAINE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:ELAINE
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 N ESKEW LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:78612-3235
Mailing Address - Country:US
Mailing Address - Phone:512-988-9288
Mailing Address - Fax:
Practice Address - Street 1:112 ENGLAND ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-2083
Practice Address - Country:US
Practice Address - Phone:804-752-2205
Practice Address - Fax:804-752-3403
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167504363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health