Provider Demographics
NPI:1972190353
Name:CALHOUN, TINISHA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:TINISHA
Middle Name:MARIE
Last Name:CALHOUN
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 1:1021 S PARK AVE APT 815
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-3942
Mailing Address - Country:US
Mailing Address - Phone:321-208-1361
Mailing Address - Fax:
Practice Address - Street 1:1021 S PARK AVE APT 815
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-3942
Practice Address - Country:US
Practice Address - Phone:321-208-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9517110163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health