Provider Demographics
NPI:1255824199
Name:PRICE, TYONNA NICOLE (CNA)
Entity Type:Individual
Prefix:
First Name:TYONNA
Middle Name:NICOLE
Last Name:PRICE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CAPEWOOD RD APT 225
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-2770
Mailing Address - Country:US
Mailing Address - Phone:352-255-6743
Mailing Address - Fax:
Practice Address - Street 1:10 CAPEWOOD RD APT 225
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-2770
Practice Address - Country:US
Practice Address - Phone:352-255-6743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor