Provider Demographics
NPI:1962247957
Name:TINER, LILLIAN P
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:P
Last Name:TINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6439 PLYMOUTH AVE STE 118W
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63133-1940
Mailing Address - Country:US
Mailing Address - Phone:314-349-1305
Mailing Address - Fax:844-854-2639
Practice Address - Street 1:6439 PLYMOUTH AVE STE 118W
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63133-1940
Practice Address - Country:US
Practice Address - Phone:314-349-1305
Practice Address - Fax:844-854-2639
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care