Provider Demographics
NPI:1568757524
Name:POLLARD, TYRONDA CHENIKA (LPN)
Entity Type:Individual
Prefix:MS
First Name:TYRONDA
Middle Name:CHENIKA
Last Name:POLLARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 BIRCHVIEW DR S
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3541
Mailing Address - Country:US
Mailing Address - Phone:614-962-1603
Mailing Address - Fax:614-866-2330
Practice Address - Street 1:6321 BIRCHVIEW DR S
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3541
Practice Address - Country:US
Practice Address - Phone:614-962-1603
Practice Address - Fax:614-866-2330
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.127205-MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse