Individual
AMANDA GRACE TINSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
D0079066
MD
2084N0400X
Neurology Physician
Primary
MD042973
DC
390200000X
Student in an Organized Health Care Education/Training Program
2011015974
MO
Other
Enumeration date
07/06/2011
Last updated
04/09/2019
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