Provider Demographics
NPI:1093227068
Name:TALTOAN, NAKEISHA DIONNE (STNA)
Entity Type:Individual
Prefix:
First Name:NAKEISHA
Middle Name:DIONNE
Last Name:TALTOAN
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 FERNCLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4613
Mailing Address - Country:US
Mailing Address - Phone:330-880-8676
Mailing Address - Fax:
Practice Address - Street 1:99 FERNCLIFF AVE
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4613
Practice Address - Country:US
Practice Address - Phone:330-880-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400106040402376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide