Provider Demographics
NPI:1730384454
Name:YOUMANS, TINA SIMS (APRN)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:SIMS
Last Name:YOUMANS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:ELAINE
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4750 WATERS AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6268
Mailing Address - Country:US
Mailing Address - Phone:912-350-5970
Mailing Address - Fax:912-350-3374
Practice Address - Street 1:4750 WATERS AVE STE 302
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6268
Practice Address - Country:US
Practice Address - Phone:912-350-5970
Practice Address - Fax:912-350-3374
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN130768363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
544900OtherWELLCARE
GAP00714516OtherRR MEDICARE
SCNP2498Medicaid
01366588OtherAMERIGROUP
GA034647725BMedicaid
GA511I500980OtherTERM'D MEDICARE PTAN
SCNP2498Medicaid