Provider Demographics
NPI:1669642518
Name:TUMMINS, ANDREA PAIGE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:PAIGE
Last Name:TUMMINS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 TUMMINS RD
Mailing Address - Street 2:
Mailing Address - City:MC EWEN
Mailing Address - State:TN
Mailing Address - Zip Code:37101-4413
Mailing Address - Country:US
Mailing Address - Phone:615-566-0526
Mailing Address - Fax:
Practice Address - Street 1:721 HIGHWAY 46 S
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2565
Practice Address - Country:US
Practice Address - Phone:615-446-3797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN110513163W00000X
TN13331363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse