Provider Demographics
NPI:1518535673
Name:TUKIA, SULIASI
Entity Type:Individual
Prefix:
First Name:SULIASI
Middle Name:
Last Name:TUKIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 TERMINAL WAY STE 125
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2198
Mailing Address - Country:US
Mailing Address - Phone:877-786-4999
Mailing Address - Fax:
Practice Address - Street 1:4260 SIERRA MADRE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6330
Practice Address - Country:US
Practice Address - Phone:775-409-6295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant