Provider Demographics
NPI:1871282749
Name:VENORSKY, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:VENORSKY
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 1:1791 MEADOWLAND DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-4809
Mailing Address - Country:US
Mailing Address - Phone:216-538-0429
Mailing Address - Fax:
Practice Address - Street 1:1791 MEADOWLAND DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-4809
Practice Address - Country:US
Practice Address - Phone:216-538-0429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker