Provider Demographics
NPI:1104704105
Name:JMAES, TIERRA A (MEDICAL ASSISTANT II)
Entity type:Individual
Prefix:
First Name:TIERRA
Middle Name:A
Last Name:JMAES
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5239 JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-1533
Mailing Address - Country:US
Mailing Address - Phone:216-609-6034
Mailing Address - Fax:
Practice Address - Street 1:5239 JOSEPH ST
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1533
Practice Address - Country:US
Practice Address - Phone:216-609-6034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 374U00000X
OH363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide