Provider Demographics
NPI:1700458361
Name:TUNKARA, KATRINA EVONNE
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:EVONNE
Last Name:TUNKARA
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 1:17207 DYNES AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-3320
Mailing Address - Country:US
Mailing Address - Phone:216-855-6513
Mailing Address - Fax:
Practice Address - Street 1:17207 DYNES AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-3320
Practice Address - Country:US
Practice Address - Phone:216-855-6513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide