Provider Demographics
NPI:1508529991
Name:TI'YE, QWEEN (RN)
Entity Type:Individual
Prefix:
First Name:QWEEN
Middle Name:
Last Name:TI'YE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 DEFENSE BLVD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20301-0001
Mailing Address - Country:US
Mailing Address - Phone:703-545-6700
Mailing Address - Fax:
Practice Address - Street 1:4000 DEFENSE BLVD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20301-3369
Practice Address - Country:US
Practice Address - Phone:703-545-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0000000000163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics