Provider Demographics
NPI:1477342103
Name:TYRELLL, LASHANDA CAMELETA
Entity type:Individual
Prefix:
First Name:LASHANDA
Middle Name:CAMELETA
Last Name:TYRELLL
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 1:134 BASIN TER
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1302
Mailing Address - Country:US
Mailing Address - Phone:724-513-0022
Mailing Address - Fax:
Practice Address - Street 1:134 BASIN TER
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1302
Practice Address - Country:US
Practice Address - Phone:724-513-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker