Provider Demographics
NPI:1497498554
Name:SANDERS, TASHAYE RENAE-DIAMOND (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:TASHAYE
Middle Name:RENAE-DIAMOND
Last Name:SANDERS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35356 TALL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-3630
Mailing Address - Country:US
Mailing Address - Phone:586-873-4005
Mailing Address - Fax:
Practice Address - Street 1:35356 TALL OAKS DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-3630
Practice Address - Country:US
Practice Address - Phone:586-873-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704362535163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health