Provider Demographics
NPI:1174039374
Name:CAVER, TANYA L
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:L
Last Name:CAVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N MAYNOR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:MS
Mailing Address - Zip Code:39367-8414
Mailing Address - Country:US
Mailing Address - Phone:601-315-0955
Mailing Address - Fax:
Practice Address - Street 1:305 N MAYNOR CREEK RD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:MS
Practice Address - Zip Code:39367-8414
Practice Address - Country:US
Practice Address - Phone:601-315-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No376J00000XNursing Service Related ProvidersHomemaker