Healthcare Provider Details

I. General information

NPI: 1386500254
Provider Name (Legal Business Name): NATASHA TANKOVICH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1987 WOLVERHAMPTON RD
POWELL OH
43065-8850
US

IV. Provider business mailing address

1987 WOLVERHAMPTON RD
POWELL OH
43065-8850
US

V. Phone/Fax

Practice location:
  • Phone: 614-264-9920
  • Fax: 614-264-9920
Mailing address:
  • Phone: 614-264-9920
  • Fax: 614-264-9920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: