Provider Demographics
NPI:1619362829
Name:LINDOW, TANA (LPN)
Entity type:Individual
Prefix:
First Name:TANA
Middle Name:
Last Name:LINDOW
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 1:2311 COACHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ATTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48412-9002
Mailing Address - Country:US
Mailing Address - Phone:810-258-0025
Mailing Address - Fax:
Practice Address - Street 1:2311 COACHWOOD DR
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:MI
Practice Address - Zip Code:48412-9002
Practice Address - Country:US
Practice Address - Phone:810-258-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703113434164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse