Provider Demographics
NPI:1720721855
Name:BROWLEY, TIANA
Entity Type:Individual
Prefix:
First Name:TIANA
Middle Name:
Last Name:BROWLEY
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 1:4624 ADKINS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-2404
Mailing Address - Country:US
Mailing Address - Phone:314-600-4658
Mailing Address - Fax:
Practice Address - Street 1:7617 S BROADWAY # 1F
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-3411
Practice Address - Country:US
Practice Address - Phone:314-912-6134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-17
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide