Provider Demographics
NPI:1659937779
Name:GREER, TYMESHA JABREE NICOLE (LPN)
Entity Type:Individual
Prefix:
First Name:TYMESHA
Middle Name:JABREE NICOLE
Last Name:GREER
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 1:119 TANDY LN
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1328
Mailing Address - Country:US
Mailing Address - Phone:216-507-7236
Mailing Address - Fax:
Practice Address - Street 1:119 TANDY LN
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1328
Practice Address - Country:US
Practice Address - Phone:216-507-7236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.170969.MEDS-IV164W00000X
OHRN.466457163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLPN.170969.MEDS-IVMedicaid