Provider Demographics
NPI:1538497896
Name:VANBUREN, TINA MARIE (RN, MSN, CCRN, CCNS)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:VANBUREN
Suffix:
Gender:F
Credentials:RN, MSN, CCRN, CCNS
Other - Prefix:MS
Other - First Name:TINA
Other - Middle Name:MARIE
Other - Last Name:MUNDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1200 S. CEDAR CREST BLVD.
Mailing Address - Street 2:LEHIGH VALLEY PHYSICIANS GROUP
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1556
Mailing Address - Country:US
Mailing Address - Phone:610-402-8707
Mailing Address - Fax:610-402-2364
Practice Address - Street 1:1200 S. CEDAR CREST BLVD
Practice Address - Street 2:MICU 2K LEHIGH VALLEY HEALTH NETWORK
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18015-1556
Practice Address - Country:US
Practice Address - Phone:610-402-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN297169L364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist