Provider Demographics
NPI:1255143749
Name:DUKES, TIANNA R
Entity type:Individual
Prefix:
First Name:TIANNA
Middle Name:R
Last Name:DUKES
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 1:801 E PULASKI HWY STE 143
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6671
Mailing Address - Country:US
Mailing Address - Phone:215-764-9676
Mailing Address - Fax:
Practice Address - Street 1:801 E PULASKI HWY STE 143
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6671
Practice Address - Country:US
Practice Address - Phone:215-764-9676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant