Provider Demographics
NPI:1306631254
Name:TIOKASIN, SIERRA ROSE (LPN)
Entity type:Individual
Prefix:MISS
First Name:SIERRA
Middle Name:ROSE
Last Name:TIOKASIN
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:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:MC LAUGHLIN
Mailing Address - State:SD
Mailing Address - Zip Code:57642-0212
Mailing Address - Country:US
Mailing Address - Phone:701-854-3831
Mailing Address - Fax:
Practice Address - Street 1:10 S RIVER RD
Practice Address - Street 2:
Practice Address - City:FORT YATES
Practice Address - State:ND
Practice Address - Zip Code:58538
Practice Address - Country:US
Practice Address - Phone:701-854-3831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDL17801164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse