Provider Demographics
NPI:1881211589
Name:THOMPSON, TONIGAH TANAE (CNA)
Entity Type:Individual
Prefix:MISS
First Name:TONIGAH
Middle Name:TANAE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PROMONTORY DR # 1
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41015-2055
Mailing Address - Country:US
Mailing Address - Phone:859-816-9431
Mailing Address - Fax:
Practice Address - Street 1:102 PROMONTORY DR # 1
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41015-2055
Practice Address - Country:US
Practice Address - Phone:859-816-9431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide