Provider Demographics
NPI:1508565516
Name:OLIVER, TASHA DARCEL
Entity Type:Individual
Prefix:MS
First Name:TASHA
Middle Name:DARCEL
Last Name:OLIVER
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 1:829 CHURCHILL HUBBARD RD APT 5
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1364
Mailing Address - Country:US
Mailing Address - Phone:330-881-2953
Mailing Address - Fax:
Practice Address - Street 1:829 CHURCHILL HUBBARD RD APT 5
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1364
Practice Address - Country:US
Practice Address - Phone:330-881-2953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide