Provider Demographics
NPI:1457654816
Name:SHTYKOVA-CURTIS, TETYANA STEPANOVNA (LPN, WCC)
Entity Type:Individual
Prefix:MS
First Name:TETYANA
Middle Name:STEPANOVNA
Last Name:SHTYKOVA-CURTIS
Suffix:
Gender:F
Credentials:LPN, WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 MERRY JOHN DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-2043
Mailing Address - Country:US
Mailing Address - Phone:937-286-4344
Mailing Address - Fax:
Practice Address - Street 1:819 MERRY JOHN DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-2043
Practice Address - Country:US
Practice Address - Phone:937-286-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 115596164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse