Healthcare Provider Details

I. General information

NPI: 1205263647
Provider Name (Legal Business Name): TANIKA FINNEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9141 RANCH MEADOWS DR
SAINT LOUIS MO
63136-3953
US

IV. Provider business mailing address

9141 RANCH MEADOWS DR
JENNINGS MO
63136-3953
US

V. Phone/Fax

Practice location:
  • Phone: 314-222-1791
  • Fax:
Mailing address:
  • Phone: 314-222-1791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0300X
TaxonomyNephrology Registered Nurse
License Number2006025728
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: