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NPI Code Detail

MEDICARE: TYANIA CHERYLE BAGGETT

MEDICARE: TYANIA CHERYLE BAGGETT
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
1171M00000XCase Manager/Care CoordinatorOH

General Provider Information

NPI Number : 1962120451
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYANIA CHERYLE BAGGETT
Provider Business Mailing Address
First Line : 1058 THUNDERBIRD AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45231-5824
Country : US
Telephone Number : 513-410-9196
Fax Number :
Provider Business Practice Location Address
First Line : 1515 CARLL ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45225-2012
Country : US
Telephone Number : 513-872-8884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2022
Last Update Date : 08/19/2022

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Directions to “ TYANIA CHERYLE BAGGETT ” Practice Location

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