Provider Demographics
NPI:1285228221
Name:NELLOM, TAUNYA RENEE' (RN)
Entity Type:Individual
Prefix:
First Name:TAUNYA
Middle Name:RENEE'
Last Name:NELLOM
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 1:10013 PIPPIN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2029
Mailing Address - Country:US
Mailing Address - Phone:513-435-4999
Mailing Address - Fax:
Practice Address - Street 1:10013 PIPPIN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2029
Practice Address - Country:US
Practice Address - Phone:513-435-4999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH338544163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse