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NPI Code Detail

MEDICARE: MISS TANASHA PERRYMOND LPN

MEDICARE:  MISS TANASHA  PERRYMOND  LPN
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
1164W00000XLicensed Practical NursePN-100578OH

General Provider Information

NPI Number : 1972762961
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TANASHA PERRYMOND LPN
Provider Business Mailing Address
First Line : 1421 E 57TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-2534
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1421 E 57TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-2534
Country : US
Telephone Number : 216-881-7061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2008
Last Update Date : 06/04/2008

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Directions to “ MISS TANASHA PERRYMOND LPN” Practice Location

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