Provider Demographics
NPI:1821207051
Name:HEARN, TINA SHALENE (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:MISS
First Name:TINA
Middle Name:SHALENE
Last Name:HEARN
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1582 PLEASANT RUN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1167
Mailing Address - Country:US
Mailing Address - Phone:513-825-8855
Mailing Address - Fax:
Practice Address - Street 1:1582 PLEASANT RUN DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-1167
Practice Address - Country:US
Practice Address - Phone:513-825-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2596123Medicaid