Provider Demographics
NPI:1922613900
Name:COLSON, TINA (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:COLSON
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 1:1861 NW 46TH AVE APT E109
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-4934
Mailing Address - Country:US
Mailing Address - Phone:754-317-8983
Mailing Address - Fax:
Practice Address - Street 1:1861 NW 46TH AVE APT E109
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-4934
Practice Address - Country:US
Practice Address - Phone:754-317-8983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health