Provider Demographics
NPI:1184034928
Name:SYX, TANAYA LYNN (RN)
Entity Type:Individual
Prefix:
First Name:TANAYA
Middle Name:LYNN
Last Name:SYX
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 1:5173 CADDY RD SW
Mailing Address - Street 2:
Mailing Address - City:BOWERSTON
Mailing Address - State:OH
Mailing Address - Zip Code:44695-9673
Mailing Address - Country:US
Mailing Address - Phone:330-735-3198
Mailing Address - Fax:
Practice Address - Street 1:5173 CADDY RD SW
Practice Address - Street 2:
Practice Address - City:BOWERSTON
Practice Address - State:OH
Practice Address - Zip Code:44695-9673
Practice Address - Country:US
Practice Address - Phone:330-735-3198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.280666163W00000X, 163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care