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NPI Code Detail

MEDICARE: CHRISTIAN LANIECE TOLBERT STNA

MEDICARE:   CHRISTIAN LANIECE TOLBERT  STNA
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
1376K00000XNurse's Aide401865920616OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1401865920616OTHEROHSTNA LICENSE

General Provider Information

NPI Number : 1669970505
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN LANIECE TOLBERT STNA
Provider Business Mailing Address
First Line : 2902 CEDAR AVE APT 37
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2983
Country : US
Telephone Number : 216-246-9103
Fax Number :
Provider Business Practice Location Address
First Line : 2902 CEDAR AVE APT 37
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2983
Country : US
Telephone Number : 216-246-9103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2018
Last Update Date : 01/25/2018

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Directions to “ CHRISTIAN LANIECE TOLBERT STNA” Practice Location

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