Provider Demographics
NPI:1831947779
Name:DEEL, TASHA ARIANE (CNA)
Entity type:Individual
Prefix:MRS
First Name:TASHA
Middle Name:ARIANE
Last Name:DEEL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MS
Other - First Name:TASHA
Other - Middle Name:ARIANE
Other - Last Name:DEEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12801 NIKE PARK RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:VA
Mailing Address - Zip Code:23314-4407
Mailing Address - Country:US
Mailing Address - Phone:757-813-0960
Mailing Address - Fax:
Practice Address - Street 1:12801 NIKE PARK RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:VA
Practice Address - Zip Code:23314-4407
Practice Address - Country:US
Practice Address - Phone:757-813-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide