Provider Demographics
NPI:1659129773
Name:CAPULONG, TITA GUIRRA (CPR, FIRST AID)
Entity type:Individual
Prefix:MRS
First Name:TITA
Middle Name:GUIRRA
Last Name:CAPULONG
Suffix:
Gender:F
Credentials:CPR, FIRST AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 WORTHINGTON WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4813
Mailing Address - Country:US
Mailing Address - Phone:614-704-6310
Mailing Address - Fax:
Practice Address - Street 1:912 WORTHINGTON WOODS BLVD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4813
Practice Address - Country:US
Practice Address - Phone:614-704-6310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker