Provider Demographics
NPI:1154092906
Name:CURETON, TASHICA RENEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:TASHICA
Middle Name:RENEE
Last Name:CURETON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CASTLE COOMBE CT
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1648
Mailing Address - Country:US
Mailing Address - Phone:810-875-1413
Mailing Address - Fax:
Practice Address - Street 1:900 W RIVER PL
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-2932
Practice Address - Country:US
Practice Address - Phone:810-875-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041407268163WC2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC2100XNursing Service ProvidersRegistered NurseContinence Care