Healthcare Provider Details

I. General information

NPI: 1073983425
Provider Name (Legal Business Name): KAMILLE TRAMIA YOUNG STNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 S GREEN RD APT 5G
SOUTH EUCLID OH
44121-3479
US

IV. Provider business mailing address

935 S GREEN RD APT 5G
SOUTH EUCLID OH
44121-3479
US

V. Phone/Fax

Practice location:
  • Phone: 216-854-4424
  • Fax:
Mailing address:
  • Phone: 216-854-4424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number401489560213
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number401489560213
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: