MEDICARE: TONYA YVETTE CREDIT

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	376K00000X	Nurse's Aide	NA0008293362	TX

General Provider Information

NPI Number	:	1558907899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA YVETTE CREDIT

Provider Business Mailing Address
First Line	:	8610 POPLAR RIDGE LN
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-2115
Country	:	US
Telephone Number	:	832-748-4274
Fax Number	:

Provider Business Practice Location Address
First Line	:	8610 POPLAR RIDGE LN
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-2115
Country	:	US
Telephone Number	:	832-748-4274
Fax Number	:

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

Provider Enumeration Date	:	11/21/2019
Last Update Date	:	11/21/2019

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Directions to “ TONYA YVETTE CREDIT ” Practice Location

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