Individual
TINA MARIE ROUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NP-C
Contact information
Practice address
132 COLONIAL DR, TOWANDA, PA 18848-8107
(570) 265-6165
(570) 265-3616
Mailing address
2476 SYLVANIA RD, TROY, PA 16947-9603
(607) 857-2589
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
542682-1
NY
163WH0200X
Home Health Registered Nurse
RN550586
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
SPO14286
PA
Other
Enumeration date
07/16/2013
Last updated
09/02/2015
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