Provider Demographics
NPI:1528862083
Name:SIMON-ELTON, TACHINICKA
Entity type:Individual
Prefix:
First Name:TACHINICKA
Middle Name:
Last Name:SIMON-ELTON
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 1:1818 STEPHANIE LN
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-4525
Mailing Address - Country:US
Mailing Address - Phone:330-475-5595
Mailing Address - Fax:
Practice Address - Street 1:1818 STEPHANIE LN
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-4525
Practice Address - Country:US
Practice Address - Phone:330-475-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health