Provider Demographics
NPI:1972360667
Name:MORROW, TIONA R
Entity Type:Individual
Prefix:
First Name:TIONA
Middle Name:R
Last Name:MORROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20390 BROOKSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4965
Mailing Address - Country:US
Mailing Address - Phone:313-405-2494
Mailing Address - Fax:
Practice Address - Street 1:14055 ASBURY PARK
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-1387
Practice Address - Country:US
Practice Address - Phone:313-405-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 171M00000X, 172A00000X, 372500000X, 372600000X
MI4704382856163WM0705X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion