Provider Demographics
NPI:1568719870
Name:KAISER, TONYA TYREE (STNA)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:TYREE
Last Name:KAISER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 NAVHAO ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:OH
Mailing Address - Zip Code:44271
Mailing Address - Country:US
Mailing Address - Phone:330-321-6733
Mailing Address - Fax:
Practice Address - Street 1:50 NAVHOO ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:OH
Practice Address - Zip Code:44217
Practice Address - Country:US
Practice Address - Phone:330-321-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401304201011376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide