Provider Demographics
NPI:1437998283
Name:PICKETT, TEONKA A
Entity type:Individual
Prefix:
First Name:TEONKA
Middle Name:A
Last Name:PICKETT
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 1:2235 YERRICK CIR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-2333
Mailing Address - Country:US
Mailing Address - Phone:330-701-9633
Mailing Address - Fax:
Practice Address - Street 1:2235 YERRICK CIR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-2333
Practice Address - Country:US
Practice Address - Phone:330-701-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker