Provider Demographics
NPI:1871928721
Name:BOWE, TIIEYA L (LPN)
Entity type:Individual
Prefix:
First Name:TIIEYA
Middle Name:L
Last Name:BOWE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26915 SENTRY LN
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1451
Mailing Address - Country:US
Mailing Address - Phone:440-385-7386
Mailing Address - Fax:
Practice Address - Street 1:26915 SENTRY LN
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1451
Practice Address - Country:US
Practice Address - Phone:440-385-7386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.148821-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse