Provider Demographics
NPI:1538797162
Name:DOWNEY, TIERENEY L (CNA, CCT)
Entity type:Individual
Prefix:
First Name:TIERENEY
Middle Name:L
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:CNA, CCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3160 LYNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-2109
Mailing Address - Country:US
Mailing Address - Phone:901-336-4411
Mailing Address - Fax:
Practice Address - Street 1:3160 LYNDALE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-2109
Practice Address - Country:US
Practice Address - Phone:901-336-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0016832251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health