Provider Demographics
NPI:1023214186
Name:HUSBAND, TIARA R (L P N)
Entity Type:Individual
Prefix:MRS
First Name:TIARA
Middle Name:R
Last Name:HUSBAND
Suffix:
Gender:F
Credentials:L P N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 KENVIEW RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-3234
Mailing Address - Country:US
Mailing Address - Phone:614-327-9326
Mailing Address - Fax:614-338-8934
Practice Address - Street 1:1801 KENVIEW RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3234
Practice Address - Country:US
Practice Address - Phone:614-327-9326
Practice Address - Fax:614-338-8934
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 096160164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse