Provider Demographics
NPI:1639316011
Name:FRANCE, TINA JAE (RN)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:JAE
Last Name:FRANCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:CANASERAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14822-9721
Mailing Address - Country:US
Mailing Address - Phone:585-704-7909
Mailing Address - Fax:
Practice Address - Street 1:2 MURRAY HILL DR
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1122
Practice Address - Country:US
Practice Address - Phone:585-243-7290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY449812-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse