Provider Demographics
NPI:1679341739
Name:TANEY, MACY
Entity Type:Individual
Prefix:
First Name:MACY
Middle Name:
Last Name:TANEY
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 1:583 FORESTEDGE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3934
Mailing Address - Country:US
Mailing Address - Phone:513-692-8852
Mailing Address - Fax:
Practice Address - Street 1:583 FORESTEDGE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3934
Practice Address - Country:US
Practice Address - Phone:513-692-8852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program