Provider Demographics
NPI:1053543256
Name:TINNIN, SANDRA ELLIOTT (CPM)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ELLIOTT
Last Name:TINNIN
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 SULPHER CREEK RD.
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37033
Mailing Address - Country:US
Mailing Address - Phone:931-729-5985
Mailing Address - Fax:931-729-5010
Practice Address - Street 1:1180 SULPHER CREEK RD.
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033
Practice Address - Country:US
Practice Address - Phone:931-729-5985
Practice Address - Fax:931-729-5010
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CPM0000000024176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife