Provider Demographics
NPI:1407333669
Name:NELSON, TIANA LYNNE SAMLOWSKI (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIANA
Middle Name:LYNNE SAMLOWSKI
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 US HIGHWAY 31 N
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2142
Mailing Address - Country:US
Mailing Address - Phone:256-230-2799
Mailing Address - Fax:
Practice Address - Street 1:101 US HIGHWAY 31 N
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2142
Practice Address - Country:US
Practice Address - Phone:256-230-2799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20509183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist