Provider Demographics
NPI:1770290157
Name:TOMLIN, MINDY (NCMA)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:TOMLIN
Suffix:
Gender:F
Credentials:NCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42942 GREEN MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-9128
Mailing Address - Country:US
Mailing Address - Phone:541-401-8907
Mailing Address - Fax:
Practice Address - Street 1:42942 GREEN MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-9128
Practice Address - Country:US
Practice Address - Phone:541-401-8907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider