MEDICARE: MS. TIEARA DOKES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN143207	LA
2	374J00000X	Doula		LA

General Provider Information

NPI Number	:	1770231193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIEARA DOKES

Provider Business Mailing Address
First Line	:	2619 MUSIC ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-7913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2619 MUSIC ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-7913
Country	:	US
Telephone Number	:	504-616-7121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2022
Last Update Date	:	03/15/2022

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