Provider Demographics
NPI:1285436758
Name:KING, TAMERA RESHONDA (BSN, RN)
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:RESHONDA
Last Name:KING
Suffix:
Gender:
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6625 ARGYLE FOREST BLVD
Mailing Address - Street 2:STE 4 1016
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6670
Mailing Address - Country:US
Mailing Address - Phone:850-724-6040
Mailing Address - Fax:
Practice Address - Street 1:157 SW ALLIANCE TRAIL
Practice Address - Street 2:#4
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340
Practice Address - Country:US
Practice Address - Phone:850-724-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL25000114697376J00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker