Provider Demographics
NPI:1245564525
Name:KNAFF, TANIESHA M (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TANIESHA
Middle Name:M
Last Name:KNAFF
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 1:619 LAFOLLETTE ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1824
Mailing Address - Country:US
Mailing Address - Phone:330-819-2316
Mailing Address - Fax:
Practice Address - Street 1:619 LAFOLLETTE ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1824
Practice Address - Country:US
Practice Address - Phone:330-819-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-19
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.123554-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse