Individual
TIELIA KERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3056 FAIR AVE, SAINT LOUIS, MO 63115-3230
(402) 598-2048
Mailing address
3056 FAIR AVE, SAINT LOUIS, MO 63115-3230
(402) 598-2048
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
2017084
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017084
CNA LICENSE
MO
Enumeration date
12/23/2021
Last updated
12/23/2021
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