Provider Demographics
NPI:1144604323
Name:NOONE, TINA MARIE (APRN)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:NOONE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:TINA
Other - Middle Name:MARIE
Other - Last Name:LATTEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:561 NW STATE ROUTE 131
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MO
Mailing Address - Zip Code:64040-9469
Mailing Address - Country:US
Mailing Address - Phone:816-826-6005
Mailing Address - Fax:
Practice Address - Street 1:11901 JESSICA LN
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-2639
Practice Address - Country:US
Practice Address - Phone:855-874-7394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015024667363LP0808X
KS77224363LP0808X
MDAC002532363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health