MEDICARE: TONYA MAXWELL

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	164W00000X	Licensed Practical Nurse	142476	OH
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1164381067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA MAXWELL

Provider Business Mailing Address
First Line	:	8563 CHERIE DR
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-2048
Country	:	US
Telephone Number	:	216-322-4943
Fax Number	:

Provider Business Practice Location Address
First Line	:	8563 CHERIE DR
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-2048
Country	:	US
Telephone Number	:	216-322-4943
Fax Number	:

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

Provider Enumeration Date	:	01/17/2026
Last Update Date	:	01/17/2026

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Directions to “ TONYA MAXWELL ” Practice Location

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