Provider Demographics
NPI:1568234011
Name:SHERENE, TINA M
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:SHERENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:M
Other - Last Name:SHERENE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:939 PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1621
Mailing Address - Country:US
Mailing Address - Phone:330-951-2476
Mailing Address - Fax:
Practice Address - Street 1:939 PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1621
Practice Address - Country:US
Practice Address - Phone:330-951-2476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty