Provider Demographics
NPI:1730844556
Name:TYE, YVONNIE RENEE
Entity type:Individual
Prefix:
First Name:YVONNIE
Middle Name:RENEE
Last Name:TYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 DENHAM ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45225-1914
Mailing Address - Country:US
Mailing Address - Phone:513-973-9234
Mailing Address - Fax:
Practice Address - Street 1:1856 DENHAM ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45225-1914
Practice Address - Country:US
Practice Address - Phone:513-973-9234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.174407.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse