Provider Demographics
NPI:1053943514
Name:TARVER, TENIECE R
Entity type:Individual
Prefix:
First Name:TENIECE
Middle Name:R
Last Name:TARVER
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 1:7436 WILLIAM REYNOLDS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-2349
Mailing Address - Country:US
Mailing Address - Phone:234-788-5876
Mailing Address - Fax:
Practice Address - Street 1:7436 WILLIAM REYNOLDS DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-2349
Practice Address - Country:US
Practice Address - Phone:234-788-5876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker