MEDICARE: TYONIA MARTIN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse	517793	OH

General Provider Information

NPI Number	:	1124564414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYONIA MARTIN RN

Provider Business Mailing Address
First Line	:	3465 MEADOWBROOK BLVD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3649
Country	:	US
Telephone Number	:	734-899-9643
Fax Number	:

Provider Business Practice Location Address
First Line	:	3594 CEDARBROOK RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3034
Country	:	US
Telephone Number	:	216-527-4670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2017
Last Update Date	:	02/09/2026

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