Provider Demographics
NPI:1700185105
Name:CUNNINGHAM, TENISHIA TASHAWN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TENISHIA
Middle Name:TASHAWN
Last Name:CUNNINGHAM
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 1:19550 EUCLID AVE
Mailing Address - Street 2:#300
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1484
Mailing Address - Country:US
Mailing Address - Phone:216-210-8997
Mailing Address - Fax:
Practice Address - Street 1:19550 EUCLID AVE
Practice Address - Street 2:#300
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1484
Practice Address - Country:US
Practice Address - Phone:216-210-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH133124164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse