Provider Demographics
NPI:1033790498
Name:HIGHTOWER, TASHIA LYNETTE (LPN)
Entity Type:Individual
Prefix:MS
First Name:TASHIA
Middle Name:LYNETTE
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 TAMARACK BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5268
Mailing Address - Country:US
Mailing Address - Phone:614-352-1790
Mailing Address - Fax:
Practice Address - Street 1:5103 TAMARACK BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5268
Practice Address - Country:US
Practice Address - Phone:614-352-1790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH177607164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse