Tyisha Anderson, LPN

Individual provider Active NPI Licensed Practical Nurse · Parma, OH

NPI 1669902896 · NPPES record last updated Jun 20, 2017

Key facts

NPI
1669902896
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LPN.161834.MEDS-IV (OH)
Practice address
5671 Chevrolet Blvd Apt 4
Parma, OH 44130-8715
Phone
(216) 258-3809
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPN.161834.MEDS-IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.161834.MEDS-IV OH Yes

Addresses

Primary practice location

5671 Chevrolet Blvd Apt 4
Parma, OH 44130-8715

Mailing address

5671 Chevrolet Blvd Apt 4
Parma, OH 44130-8715

Other providers in Parma, OH

All providers in Parma, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.