Healthcare Provider Details

I. General information

NPI: 1124998919
Provider Name (Legal Business Name): TINARENEA CONWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2257 E 82ND ST
CLEVELAND OH
44103-5007
US

IV. Provider business mailing address

2257 E 82ND ST
CLEVELAND OH
44103-5007
US

V. Phone/Fax

Practice location:
  • Phone: 216-334-3941
  • Fax:
Mailing address:
  • Phone: 216-334-3941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberRP910916
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberRP910916
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberRP910916
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: