Provider Demographics
NPI:1962889048
Name:TINANA, DOVIE NILE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:DOVIE
Middle Name:NILE
Last Name:TINANA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:DOVIE
Other - Middle Name:NILE
Other - Last Name:INES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5284 CAMELOT FOREST DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-1533
Mailing Address - Country:US
Mailing Address - Phone:904-292-3986
Mailing Address - Fax:
Practice Address - Street 1:4475 SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-3357
Practice Address - Country:US
Practice Address - Phone:904-389-0314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2881362363LF0000X
FLAPRN2881362363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily