Provider Demographics
NPI:1891219697
Name:SPICER, TAMIKA YVETTE
Entity type:Individual
Prefix:MS
First Name:TAMIKA
Middle Name:YVETTE
Last Name:SPICER
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 1:6640 HUMBOLDT AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-1862
Mailing Address - Country:US
Mailing Address - Phone:720-709-0573
Mailing Address - Fax:
Practice Address - Street 1:6640 HUMBOLDT AVE N
Practice Address - Street 2:101
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430
Practice Address - Country:US
Practice Address - Phone:720-709-0573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty