Provider Demographics
NPI:1689390700
Name:HARRISON, TAWANA MICHELE
Entity Type:Individual
Prefix:
First Name:TAWANA
Middle Name:MICHELE
Last Name:HARRISON
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 1:620 INVERNESS RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-4521
Mailing Address - Country:US
Mailing Address - Phone:228-365-5835
Mailing Address - Fax:
Practice Address - Street 1:620 INVERNESS RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-4521
Practice Address - Country:US
Practice Address - Phone:228-365-5835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide