Provider Demographics
NPI:1750939948
Name:TUTSTONE, ONESTIE
Entity type:Individual
Prefix:MISS
First Name:ONESTIE
Middle Name:
Last Name:TUTSTONE
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 1:1356 W 85TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-1878
Mailing Address - Country:US
Mailing Address - Phone:216-889-3865
Mailing Address - Fax:
Practice Address - Street 1:1356 W 85TH ST APT 1
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-1878
Practice Address - Country:US
Practice Address - Phone:216-889-3865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0267204Medicaid