MEDICARE: TARONICA CNA

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	372600000X	Adult Companion	NA08876222	TX
2	376J00000X	Homemaker	NA08876222	TX
3	374U00000X	Home Health Aide	NA08876222	TX

General Provider Information

NPI Number	:	1154666014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TARONICA CNA

Provider Business Mailing Address
First Line	:	2015 TEAGARDEN CT
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75217-8684
Country	:	US
Telephone Number	:	214-403-1477
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 TEAGARDEN CT
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75217-8684
Country	:	US
Telephone Number	:	214-403-1477
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS TARONICA SHAMEL COLLINS
Credential	:	CNA
Telephone Number	:	214-403-1477

Provider Enumeration Date	:	12/04/2012
Last Update Date	:	12/04/2012

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