Crumble, Tatanisha
Crumble, Tatanisha is an sole proprietor health care provider with primary practice located at 623 Slate Dr Apt B , Indianapolis IN 46227-5086. She recently has only one registered license in Respite Care Facility / Respite Care, Mental Illness, Child, which is considered as her primary health care specialty. Crumble, Tatanisha can be contacted via phone (317) 238-0294.Contact Information
Primary practice address
623 Slate Dr Apt B
Indianapolis IN 46227-5086
Phone: (317) 238-0294
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respite Care Facility / Respite Care, Mental Illness, Child | 385HR2055X |
Profile Details
| NPI number | 1548900194 |
|---|---|
| LBN Legal business name | Crumble, Tatanisha |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2022 |
| Last updated | Mar 31st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548900194 | NPPES |
| Indiana | MEDICAID | 00000000 |
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