Audra Deborah Tinnin, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2024007271 Issued in MO

Practice address

612 E 10TH St
Holden, MO 64040-9421

Phone

(816) 732-6010

Fax

(816) 732-6011

NPI assigned

Feb 27, 2024

Last updated

Feb 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holden Family Care, LLC

  • Rural Health Clinic/Center
  • Holden, MO
  • NPI 1205154606
  NPD
• Holden Family Care, LLC

  • Family Nurse Practitioner
  • Holden, MO
  • NPI 1215396338
  NPD (past)

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1700642691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12614 FOUNTAIN LAKE DR",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640301595",
            "telephone_number": "918-851-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E 10TH ST",
            "city": "HOLDEN",
            "state": "MO",
            "postal_code": "640409421",
            "telephone_number": "816-732-6010",
            "fax_number": "816-732-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINNIN",
        "first_name": "AUDRA",
        "middle_name": "DEBORAH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024007271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Maddox
• Midwest Division-LSH.LLC (Holden Family Health Clinic)
• Midwest Dysphagia Diagnostics PC
• Brandon Michael Sullivan, PHARMD
• The Dyslexia Den
• Trevi Enterprises LLC
• Dana J Van Meter Patton, M.S. CCC-SLP/L
• Wilkinson Pharmacy Inc (Wilkinson Home Care Equipment)
• James R Wirkkula, D.O.

• Family Nurse Practitioner in Holden, MO
• Providers in Holden, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.