Individual
TASHIANA ETHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1607 N LINCOLN ST, KNOXVILLE, IA 50138-3455
(641) 828-5019
Mailing address
710 E COMPETINE ST, KNOXVILLE, IA 50138-1911
(641) 218-9595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
129677
IA
Other
Enumeration date
11/27/2020
Last updated
11/27/2020
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