Provider Demographics
NPI:1669854949
Name:CARRINGTON, TINA SUZANNE
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:SUZANNE
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 ALABASTER TRL
Mailing Address - Street 2:
Mailing Address - City:YELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72687-9712
Mailing Address - Country:US
Mailing Address - Phone:501-771-1721
Mailing Address - Fax:870-436-6827
Practice Address - Street 1:913 ALABASTER TRL
Practice Address - Street 2:
Practice Address - City:YELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72687-9712
Practice Address - Country:US
Practice Address - Phone:501-771-1721
Practice Address - Fax:870-436-6827
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator