Provider Demographics
NPI:1194025601
Name:CRENSHAW, TAUSHA ROCHE' (LPN)
Entity Type:Individual
Prefix:
First Name:TAUSHA
Middle Name:ROCHE'
Last Name:CRENSHAW
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 1:430 CLINTON SPRINGS AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45217-1945
Mailing Address - Country:US
Mailing Address - Phone:513-288-6965
Mailing Address - Fax:
Practice Address - Street 1:430 CLINTON SPRINGS AVE
Practice Address - Street 2:APT 3
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45217-1945
Practice Address - Country:US
Practice Address - Phone:513-288-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-31
Last Update Date:2010-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.138516-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse