Provider Demographics
NPI:1326636630
Name:POYNTER, TIFFENEY DENISE (MHA, LPN)
Entity Type:Individual
Prefix:MRS
First Name:TIFFENEY
Middle Name:DENISE
Last Name:POYNTER
Suffix:
Gender:F
Credentials:MHA, LPN
Other - Prefix:MRS
Other - First Name:TIFFENEY
Other - Middle Name:
Other - Last Name:POYNTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHA, LPN
Mailing Address - Street 1:7301 FEGENBUSH LN UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40228-1578
Mailing Address - Country:US
Mailing Address - Phone:502-347-2237
Mailing Address - Fax:502-347-2240
Practice Address - Street 1:7301 FEGENBUSH LN
Practice Address - Street 2:STE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40228-1578
Practice Address - Country:US
Practice Address - Phone:502-347-2237
Practice Address - Fax:502-347-2240
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2036219164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse