Provider Demographics
NPI:1700659380
Name:FUCHS, TRANEDA MICHELLE (LPN)
Entity Type:Individual
Prefix:
First Name:TRANEDA
Middle Name:MICHELLE
Last Name:FUCHS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15085 S ELWOOD AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-4046
Mailing Address - Country:US
Mailing Address - Phone:804-306-9972
Mailing Address - Fax:
Practice Address - Street 1:15085 S ELWOOD AVE STE 105
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-4046
Practice Address - Country:US
Practice Address - Phone:804-306-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0039936164W00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical Nurse