Provider Demographics
NPI:1225893431
Name:ALLENSWORTH, TOSHEA M
Entity Type:Individual
Prefix:MISS
First Name:TOSHEA
Middle Name:M
Last Name:ALLENSWORTH
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 1:1045 N BELLEVIEW PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-3177
Mailing Address - Country:US
Mailing Address - Phone:317-450-8887
Mailing Address - Fax:
Practice Address - Street 1:1045 N BELLEVIEW PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-3177
Practice Address - Country:US
Practice Address - Phone:317-450-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty