Provider Demographics
NPI:1306175583
Name:TINNEY, AMY RAVEL (MSN, FNP-C, CPM , LM)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:RAVEL
Last Name:TINNEY
Suffix:
Gender:F
Credentials:MSN, FNP-C, CPM , LM
Other - Prefix:
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Mailing Address - Street 1:6338 VISTA DEL MAR
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7540
Mailing Address - Country:US
Mailing Address - Phone:424-835-4186
Mailing Address - Fax:310-421-1414
Practice Address - Street 1:6338 VISTA DEL MAR
Practice Address - Street 2:
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-7540
Practice Address - Country:US
Practice Address - Phone:424-835-4186
Practice Address - Fax:310-421-1414
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2024-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA661352163W00000X, 163WM0102X
CALM254176B00000X
CA95019865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No176B00000XOther Service ProvidersMidwife