Provider Demographics
NPI:1679195739
Name:LINDSEY, TASHA AMARA
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:AMARA
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 VIENNA WOODS DR # 7
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-6080
Mailing Address - Country:US
Mailing Address - Phone:513-259-3385
Mailing Address - Fax:
Practice Address - Street 1:1407 VIENNA WOODS DR # 7
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-6080
Practice Address - Country:US
Practice Address - Phone:513-259-3385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH133664164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSV930800OtherDRIVERS LICENSE