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General NPI Number Information
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NPI Number | 1811709967
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Entity Type | Individual
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Provider Name | TANIYHA WOODBERRY
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Gender | Female
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 1410 WATER OAK WAY S
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City | BRADENTON
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State | FL
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Zip | 34209-7832
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Country | US
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Telephone | 734-358-3859
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Fax |
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Provider Business Mailing Address
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Address Line | 5580 FOUNTAIN LAKE CIR APT 223
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City | BRADENTON
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State | FL
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Zip | 34207-3739
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Country | US
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Telephone | 813-582-6477
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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