Provider Demographics
NPI:1518573294
Name:MCKNIGHT-CURRY, TAHESIA
Entity Type:Individual
Prefix:
First Name:TAHESIA
Middle Name:
Last Name:MCKNIGHT-CURRY
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 1:8401 SOUTHSIDE BLVD APT 922
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1605
Mailing Address - Country:US
Mailing Address - Phone:904-758-1503
Mailing Address - Fax:
Practice Address - Street 1:8401 SOUTHSIDE BLVD APT 922
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1605
Practice Address - Country:US
Practice Address - Phone:904-758-1503
Practice Address - Fax:336-652-3155
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No171400000XOther Service ProvidersHealth & Wellness Coach
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker