Provider Demographics
NPI:1245027291
Name:LYLES, TE'ASIA ANDERA (STNA)
Entity type:Individual
Prefix:MS
First Name:TE'ASIA
Middle Name:ANDERA
Last Name:LYLES
Suffix:
Gender:
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 EUCLID AVE APT 709
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-1650
Mailing Address - Country:US
Mailing Address - Phone:216-600-7629
Mailing Address - Fax:
Practice Address - Street 1:1101 EUCLID AVE APT 709
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-1650
Practice Address - Country:US
Practice Address - Phone:216-600-7629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602959090225376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide