Provider Demographics
NPI:1801401310
Name:TENANT, YVONNE DENICE
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:DENICE
Last Name:TENANT
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 1:2466 CRYSTAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-6905
Mailing Address - Country:US
Mailing Address - Phone:614-530-7970
Mailing Address - Fax:
Practice Address - Street 1:2466 CRYSTAL SPRINGS DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-6905
Practice Address - Country:US
Practice Address - Phone:614-530-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide