Healthcare Provider Details

I. General information

NPI: 1528391562
Provider Name (Legal Business Name): TONYA BESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10261 ROCHESTER COZADDALE RD
GOSHEN OH
45122-9643
US

IV. Provider business mailing address

10261 ROCHESTER COZADDALE RD
GOSHEN OH
45122-9643
US

V. Phone/Fax

Practice location:
  • Phone: 513-678-5559
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN080270
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: