Provider Demographics
NPI:1144463167
Name:SAILES, TONIA ASIS RAY (LPN)
Entity type:Individual
Prefix:
First Name:TONIA
Middle Name:ASIS RAY
Last Name:SAILES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 ROCKEFELLER RD
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-2023
Mailing Address - Country:US
Mailing Address - Phone:440-278-4631
Mailing Address - Fax:
Practice Address - Street 1:2310 ROCKEFELLER RD
Practice Address - Street 2:
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092-2023
Practice Address - Country:US
Practice Address - Phone:440-278-4631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 126533 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse