Provider Demographics
NPI:1295576924
Name:CREED, THASHA
Entity type:Individual
Prefix:
First Name:THASHA
Middle Name:
Last Name:CREED
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 1:324 GREGG ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-1450
Mailing Address - Country:US
Mailing Address - Phone:740-505-8432
Mailing Address - Fax:
Practice Address - Street 1:4692 CAMP GROVE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-8714
Practice Address - Country:US
Practice Address - Phone:937-661-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide