Provider Demographics
NPI:1023703998
Name:DELONEY, TYSHANTA NICOLE (NURSING ASSIANT)
Entity type:Individual
Prefix:
First Name:TYSHANTA
Middle Name:NICOLE
Last Name:DELONEY
Suffix:
Gender:F
Credentials:NURSING ASSIANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7519 DORR ST LOT 190
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4148
Mailing Address - Country:US
Mailing Address - Phone:419-467-1594
Mailing Address - Fax:
Practice Address - Street 1:7519 DORR ST LOT 190
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-4148
Practice Address - Country:US
Practice Address - Phone:419-467-1594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400092990302376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide