Healthcare Provider Details

I. General information

NPI: 1629675103
Provider Name (Legal Business Name): TISHENA NICOLE LLOYD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1249 15TH ST STE 3000
HUNTINGTON WV
25701-3663
US

IV. Provider business mailing address

1448 10TH AVE STE 304
HUNTINGTON WV
25701-3579
US

V. Phone/Fax

Practice location:
  • Phone: 304-691-1000
  • Fax: 304-691-1693
Mailing address:
  • Phone: 304-733-8728
  • Fax: 304-691-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number36218
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number36218
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: