Provider Demographics
NPI:1972784577
Name:TINSLEY, MICHELLE (CNP-FNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:CNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 MEMORIAL DR BLDG 4
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76711-1329
Mailing Address - Country:US
Mailing Address - Phone:800-423-2111
Mailing Address - Fax:254-297-5393
Practice Address - Street 1:4800 MEMORIAL DR BLDG 4
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76711-1329
Practice Address - Country:US
Practice Address - Phone:800-423-2111
Practice Address - Fax:254-297-5393
Is Sole Proprietor?:No
Enumeration Date:2007-11-25
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08512363LF0000X, 363LF0000X
TXAP143792363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily