Doctor Name: | TIOCKA BENTLEY |
NPI Number: | 1073930848 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN |
License Number: | 4703093522 |
Business Practice Address: | 1450 Leonard St Ne Grand Rapids, MI - 495055515 |
Business Phone Number: | 6167748789 |
Business Fax Number: | 6167761305 |
Mailing Address: | 1450 Leonard St Ne, GRAND RAPIDS |
State: | MI |
Postal Code: | 495055515 |
Phone Number: | 6167748789 |
Fax Number: | 6167761305 |
NPI Enumeration Date: | 03/18/2014 |
NPI Last Update Date: | 03/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 4703093522 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |