Provider Demographics
NPI:1194894741
Name:HALES, TAHNEE DEE (RN)
Entity type:Individual
Prefix:MRS
First Name:TAHNEE
Middle Name:DEE
Last Name:HALES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TAHNEE
Other - Middle Name:DEE
Other - Last Name:KILFIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4310 CURVE ROAD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015
Mailing Address - Country:US
Mailing Address - Phone:740-362-5259
Mailing Address - Fax:740-362-5259
Practice Address - Street 1:4310 CURVE RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015
Practice Address - Country:US
Practice Address - Phone:740-362-5259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN253941163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0183082Medicaid