Provider Demographics
NPI:1609004217
Name:SNEED, TANISHA TIARA (LPN)
Entity Type:Individual
Prefix:
First Name:TANISHA
Middle Name:TIARA
Last Name:SNEED
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 1:560 PARKHILL DR APT 5
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-9149
Mailing Address - Country:US
Mailing Address - Phone:330-858-4623
Mailing Address - Fax:
Practice Address - Street 1:560 PARKHILL DR APT 5
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-9149
Practice Address - Country:US
Practice Address - Phone:330-858-4623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH132626164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse