Provider Demographics
NPI:1285236232
Name:NAKOFF, TERESA ANN
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:NAKOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:281 ANTIOCH RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-9364
Mailing Address - Country:US
Mailing Address - Phone:937-768-8802
Mailing Address - Fax:
Practice Address - Street 1:281 ANTIOCH RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-9364
Practice Address - Country:US
Practice Address - Phone:937-768-8802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant