Provider Demographics
NPI:1407603103
Name:O'NEAL, KEYASHA RITA JOHNAY
Entity type:Individual
Prefix:
First Name:KEYASHA
Middle Name:RITA JOHNAY
Last Name:O'NEAL
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 1:2708 E TOWER DR APT 510
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-6437
Mailing Address - Country:US
Mailing Address - Phone:513-510-2210
Mailing Address - Fax:
Practice Address - Street 1:2373 MERRIWAY LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-1722
Practice Address - Country:US
Practice Address - Phone:513-498-1367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant