Provider Demographics
NPI:1942030846
Name:HARTWELL, TAMEYA L
Entity type:Individual
Prefix:
First Name:TAMEYA
Middle Name:L
Last Name:HARTWELL
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 1:7339 SPINNAKER BAY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7671
Mailing Address - Country:US
Mailing Address - Phone:267-237-5507
Mailing Address - Fax:
Practice Address - Street 1:9355 E 60TH TER
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-3803
Practice Address - Country:US
Practice Address - Phone:267-237-5507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver