Provider Demographics
NPI:1508300500
Name:GOINS, TIARA M (LPN)
Entity Type:Individual
Prefix:
First Name:TIARA
Middle Name:M
Last Name:GOINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 LEGION LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-5494
Mailing Address - Country:US
Mailing Address - Phone:614-439-2202
Mailing Address - Fax:
Practice Address - Street 1:3250 LEGION LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-5494
Practice Address - Country:US
Practice Address - Phone:614-439-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH159624164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse