Provider Demographics
NPI:1932665122
Name:TINSLEY, STEPHANIE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MARIE
Other - Last Name:TALKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10824 SHAWNEE MISSION PKWY
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-3512
Mailing Address - Country:US
Mailing Address - Phone:913-297-7472
Mailing Address - Fax:913-248-7631
Practice Address - Street 1:10824 SHAWNEE MISSION PKWY
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-3512
Practice Address - Country:US
Practice Address - Phone:913-297-7472
Practice Address - Fax:913-248-7631
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019005036363LF0000X
KS53-78594-121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily