Provider Demographics
NPI:1063560225
Name:ESCOYNE, TINA CHERYL (FNP-BC, ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:CHERYL
Last Name:ESCOYNE
Suffix:
Gender:F
Credentials:FNP-BC, ACNP-BC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:CHERYL
Other - Last Name:BROWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 CARIBOU CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-1564
Mailing Address - Country:US
Mailing Address - Phone:303-868-0582
Mailing Address - Fax:
Practice Address - Street 1:3600 FM 1488 RD STE 200
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3867
Practice Address - Country:US
Practice Address - Phone:936-447-9812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX835899363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34672869Medicaid
CO808380Medicare PIN
CO34672869Medicaid
CO808380Medicare Oscar/Certification
CO808380Medicare UPIN