Provider Demographics
NPI:1851509533
Name:WELCH-TYNER, NATASHA N (LPN)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:N
Last Name:WELCH-TYNER
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 1:3216 EUCLID HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1876
Mailing Address - Country:US
Mailing Address - Phone:216-926-8089
Mailing Address - Fax:
Practice Address - Street 1:3216 EUCLID HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1876
Practice Address - Country:US
Practice Address - Phone:216-926-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121663164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse