Healthcare Provider Details

I. General information

NPI: 1013632827
Provider Name (Legal Business Name): TEAISHA INIQUE MURRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14579 BARTTER AVE
CLEVELAND OH
44111-3101
US

IV. Provider business mailing address

14579 BARTTER AVE APT 214
CLEVELAND OH
44111-3101
US

V. Phone/Fax

Practice location:
  • Phone: 216-319-9960
  • Fax:
Mailing address:
  • Phone: 216-319-9960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: