Tynia Childs, RN
Individual provider Active NPI Addiction (Substance Use Disorder) Registered Nurse · Monticello, NY
NPI 1508176397 · NPPES record last updated Sep 16, 2024
Key facts
- NPI
- 1508176397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse 163WA0400X
- License
- 322787 (NC)
- Practice address
- 685 W Broadway Apt 7K
Monticello, NY 12701-7154 - Phone
- (845) 428-5554
- NPI assigned
- Oct 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 322787 | NC | MD | Addiction (Substance Use Disorder) Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 322787 | NC | Yes |
Addresses
Primary practice location
685 W Broadway Apt 7K
Monticello, NY 12701-7154
Mailing address
55 Grassy Springs CT
Oxford, GA 30054-3012
Phone (470) 314-1943
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508176397 | Medicaid | NY |
Other providers in Monticello, NY
- Rachel Gail Chaiet
- Kathy A Chapin
- Marylynn Charnas
- Wing Chau
- Joyce Ann Checksfield
- Debra Chin
- Jamie Lynn Ciabattari
- Kristi Marie Cianfichi
- Diann Clansy
- Alan Bruce Cohen
All providers in Monticello, NY · Addiction (Substance Use Disorder) Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.