Tanna Lynn Bolden
Individual provider Active NPI Nurse's Aide · Wauseon, OH
NPI 1831601079 · NPPES record last updated Oct 27, 2017
Key facts
- NPI
- 1831601079
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 324290670817 (OH)
- Practice address
- 312 Barbara Dr
Wauseon, OH 43567-8881 - Phone
- (567) 454-1435
- NPI assigned
- Oct 27, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 324290670817 | OH | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 324290670817 | OH | Yes |
Addresses
Primary practice location
312 Barbara Dr
Wauseon, OH 43567-8881
Mailing address
312 Barbara Dr
Wauseon, OH 43567-8881
Phone (567) 454-1435
Other providers in Wauseon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.