Provider Demographics
NPI:1790835007
Name:TINSLEY, JANET LYNN (BA)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:LYNN
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 HERITAGE LN
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7055
Mailing Address - Country:US
Mailing Address - Phone:727-851-1675
Mailing Address - Fax:
Practice Address - Street 1:2719 HERITAGE LN
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7055
Practice Address - Country:US
Practice Address - Phone:727-851-1675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL764531700Medicaid