Provider Demographics
NPI:1326649310
Name:WILLIAMSON, TASHANA STERLING
Entity Type:Individual
Prefix:MISS
First Name:TASHANA
Middle Name:STERLING
Last Name:WILLIAMSON
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 1:501 NYE ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4641
Mailing Address - Country:US
Mailing Address - Phone:419-860-8831
Mailing Address - Fax:
Practice Address - Street 1:501 NYE ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4641
Practice Address - Country:US
Practice Address - Phone:419-860-8831
Practice Address - Fax:419-860-8831
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH402222731119163WH0200X
OH422222731119376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7480Medicaid
OH0812Medicaid
OH2300Medicaid