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Individual
TINA MARIE ANDERSON
Active
Individual
TINA MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R169331
MD
363LN0000X
Neonatal Nurse Practitioner
Primary
0024167147
VA
363LN0000X
Neonatal Nurse Practitioner
R169331
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024167147
BOARD OF NURSING
VA
01
—
R169331
LIC.
MD
Enumeration date
03/22/2007
Last updated
06/24/2025
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