Provider Demographics
NPI:1336669274
Name:HIGHTOWER, TANNIKA Q (LPN)
Entity Type:Individual
Prefix:
First Name:TANNIKA
Middle Name:Q
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:TANNIKA
Other - Middle Name:QUINETTE
Other - Last Name:HIGHTOWER-COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:617 STERLING SPUR AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-3010
Mailing Address - Country:US
Mailing Address - Phone:323-381-0941
Mailing Address - Fax:
Practice Address - Street 1:617 STERLING SPUR AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-3010
Practice Address - Country:US
Practice Address - Phone:323-381-0941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289236164X00000X
NV17129164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse