Provider Demographics
NPI:1346069945
Name:JAMES, TAWANA LYNN
Entity type:Individual
Prefix:
First Name:TAWANA
Middle Name:LYNN
Last Name:JAMES
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 1:2000 MALVERN AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-4457
Mailing Address - Country:US
Mailing Address - Phone:937-699-0279
Mailing Address - Fax:
Practice Address - Street 1:2000 MALVERN AVE APT 4
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-4457
Practice Address - Country:US
Practice Address - Phone:937-699-0279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376977910498376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide