Individual
TYSHAUNNA NICCOYA ALCORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STATE TESTED NURSING
Contact information
Practice address
555 E 102ND ST, CLEVELAND, OH 44108-1370
(216) 482-5723
Mailing address
555 E 102ND ST, CLEVELAND, OH 44108-1370
(216) 482-5723
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401553030713
OH
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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