Provider Demographics
NPI:1356234512
Name:ABRAMS, TIANA L
Entity type:Individual
Prefix:
First Name:TIANA
Middle Name:L
Last Name:ABRAMS
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 1:31 E CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:WV
Mailing Address - Zip Code:26032-3002
Mailing Address - Country:US
Mailing Address - Phone:304-975-0686
Mailing Address - Fax:
Practice Address - Street 1:31 E CAMPUS DR
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:WV
Practice Address - Zip Code:26032-3002
Practice Address - Country:US
Practice Address - Phone:304-975-0686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1821206228Medicaid
WV1255553494Medicaid
WV1356607394Medicaid