MEDICARE: TEONNA M HARVEY

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1386262731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEONNA M HARVEY

Provider Business Mailing Address
First Line	:	2551 GRANTWOOD DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-3808
Country	:	US
Telephone Number	:	419-260-7755
Fax Number	:

Provider Business Practice Location Address
First Line	:	2551 GRANTWOOD DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-3808
Country	:	US
Telephone Number	:	419-260-7755
Fax Number	:

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

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	07/13/2020

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Directions to “ TEONNA M HARVEY ” Practice Location

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