Provider Demographics
NPI:1861604951
Name:NARED, TAMIKA NICOLE (LPN)
Entity type:Individual
Prefix:MISS
First Name:TAMIKA
Middle Name:NICOLE
Last Name:NARED
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:PO BOX 12494
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-0494
Mailing Address - Country:US
Mailing Address - Phone:267-972-8794
Mailing Address - Fax:
Practice Address - Street 1:5429 GERMANTOWN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-2223
Practice Address - Country:US
Practice Address - Phone:215-754-0240
Practice Address - Fax:215-754-0513
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN265090251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care