Provider Demographics
NPI:1568032993
Name:EDMERSON, TONEKA
Entity Type:Individual
Prefix:MRS
First Name:TONEKA
Middle Name:
Last Name:EDMERSON
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 1:7710 READING RD STE 107A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-2809
Mailing Address - Country:US
Mailing Address - Phone:513-413-8823
Mailing Address - Fax:513-672-9901
Practice Address - Street 1:7710 READING RD STE 107A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-2809
Practice Address - Country:US
Practice Address - Phone:513-413-8823
Practice Address - Fax:513-672-9901
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide