Tina Marie Sudduth, REGISTERED NURSE

Primary specialty

Low-Risk Neonatal Registered NurseTaxonomy code 163WN0003X

License

396021 Issued in CA

Practice address

14191 Yale St
Hesperia, CA 92344-8290

Phone

(909) 855-1545

NPI assigned

Jan 12, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1134424781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14191 YALE ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923448290",
            "telephone_number": "909-855-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14191 YALE ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923448290",
            "telephone_number": "909-855-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "CA",
            "license": "396021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Jon Storm, DC
• Jill Streiff, PHARM D
• Solana Jamesia Strickland
• Guilbert T Stroschein, D.D.S.,M.D.
• Piala Styadi, PHARM. D
• Summit Leadership Academy - High Desert
• Desiree Sundeen
• Sung M. Ahn, D.D.S., Inc.
• Stephen John Svastits, D.C.,C.C.S.P.,I.D.E.
• Makinzie Sweet

• Registered Nurse in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.