Provider Demographics
NPI:1003403882
Name:DOSS, TIEARA RENEA (LPN)
Entity Type:Individual
Prefix:MS
First Name:TIEARA
Middle Name:RENEA
Last Name:DOSS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5676 BROADVIEW RD APT 530
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-1642
Mailing Address - Country:US
Mailing Address - Phone:440-862-1447
Mailing Address - Fax:
Practice Address - Street 1:5676 BROADVIEW RD APT 530
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-1642
Practice Address - Country:US
Practice Address - Phone:144-086-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.176583.MEDS.IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse