Individual
MS. TINA LOUISE VAN DOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP, CPNP-PC, MSN
Contact information
Practice address
4040 49TH ST N, ST PETERSBURG, FL 33709-5734
(727) 526-6483
Mailing address
4040 49TH ST N, ST PETERSBURG, FL 33709-5734
(727) 526-6483
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9170633
FL
Other
Enumeration date
05/20/2009
Last updated
08/18/2011
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