Provider Demographics
NPI:1336931146
Name:MAJOR, TIJA LAVINE (FNP)
Entity type:Individual
Prefix:MRS
First Name:TIJA
Middle Name:LAVINE
Last Name:MAJOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:TIJA
Other - Middle Name:JANEE'
Other - Last Name:LAVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 395
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70722-0395
Mailing Address - Country:US
Mailing Address - Phone:225-683-5292
Mailing Address - Fax:225-683-1310
Practice Address - Street 1:11990 JACKSON ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:LA
Practice Address - Zip Code:70722-3210
Practice Address - Country:US
Practice Address - Phone:225-683-5292
Practice Address - Fax:225-683-1310
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN152437163WN0300X
LA242716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA242716OtherSTATE LICENSE