MEDICARE: ERIONNE THOMAS 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
1	376K00000X	Nurse's Aide	400881170309	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932869047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIONNE THOMAS STNA

Provider Business Mailing Address
First Line	:	10116 RICHLAND AVE
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-1605
Country	:	US
Telephone Number	:	216-804-9663
Fax Number	:

Provider Business Practice Location Address
First Line	:	10116 RICHLAND AVE
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-1605
Country	:	US
Telephone Number	:	216-804-9663
Fax Number	:

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

Provider Enumeration Date	:	12/30/2021
Last Update Date	:	12/30/2021

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Directions to “ ERIONNE THOMAS STNA” Practice Location

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