Tyione Lamar Russell
Technician, Attendant Care Provider in Greensboro, NC. Individual provider (NPI-1).
NPI number1972248250
StatusActive
Last updated in NPPESMay 2, 2022
Details
- NPI
- 1972248250
- Entity type
- Individual (NPI-1)
- Name
- Tyione Lamar Russell
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 2, 2022
- Certification date
- May 2, 2022
- Last updated
- May 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
3606 Lakefield Dr Apt FGreensboro, NC 27406-5800
Phone 336-840-0574
Mailing address
3606 Lakefield Dr Apt FGreensboro, NC 27406-5800
Phone 336-840-0574
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