Provider Demographics
NPI:1033705785
Name:SWEENEY, TIERA
Entity Type:Individual
Prefix:
First Name:TIERA
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 GRANADA BLVD
Mailing Address - Street 2:APT 109
Mailing Address - City:WARRENSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44128
Mailing Address - Country:US
Mailing Address - Phone:216-403-4079
Mailing Address - Fax:
Practice Address - Street 1:4501 GRANADA BLVD
Practice Address - Street 2:APT 109
Practice Address - City:WARRENSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44128
Practice Address - Country:US
Practice Address - Phone:216-403-4079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker