Provider Demographics
NPI:1730260589
Name:LINSALATA, TINA (CRNFA)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:LINSALATA
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11806 ALLWOOD PATH
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2034
Mailing Address - Country:US
Mailing Address - Phone:512-280-2199
Mailing Address - Fax:512-280-2207
Practice Address - Street 1:11806 ALLWOOD PATH
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-2034
Practice Address - Country:US
Practice Address - Phone:512-280-2199
Practice Address - Fax:512-280-2207
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2010-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621637163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0047HTOtherBLUE CROSS PROVIDER NUMBE
TX89N952OtherBLUE CROSS PROVIDER NUMBE