Provider Demographics
NPI:1871180364
Name:BYRD, TAMYRA IRENE
Entity Type:Individual
Prefix:MISS
First Name:TAMYRA
Middle Name:IRENE
Last Name:BYRD
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 1:212 EARL NORTH DR
Mailing Address - Street 2:
Mailing Address - City:HASKINS
Mailing Address - State:OH
Mailing Address - Zip Code:43525-9512
Mailing Address - Country:US
Mailing Address - Phone:567-868-4990
Mailing Address - Fax:
Practice Address - Street 1:212 EARL NORTH DR
Practice Address - Street 2:
Practice Address - City:HASKINS
Practice Address - State:OH
Practice Address - Zip Code:43525-9512
Practice Address - Country:US
Practice Address - Phone:567-868-4990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172A00000X, 372500000X, 376J00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker