Provider Demographics
NPI:1104403708
Name:GRINSTEINER, TINA (APRN-RNP)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:GRINSTEINER
Suffix:
Gender:F
Credentials:APRN-RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14338 E 49TH DR
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-8705
Mailing Address - Country:US
Mailing Address - Phone:931-414-0326
Mailing Address - Fax:
Practice Address - Street 1:9559 W PINNACLE VISTA DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-8715
Practice Address - Country:US
Practice Address - Phone:623-980-2844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ255720163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ255720OtherAPRN-RNP LICENSE