Provider Demographics
NPI:1992107213
Name:JOHNS, TAMIKO (LPN)
Entity type:Individual
Prefix:
First Name:TAMIKO
Middle Name:
Last Name:JOHNS
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 1:136 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:MC KENZIE
Mailing Address - State:TN
Mailing Address - Zip Code:38201-1704
Mailing Address - Country:US
Mailing Address - Phone:407-758-6397
Mailing Address - Fax:
Practice Address - Street 1:136 CARROLL ST
Practice Address - Street 2:
Practice Address - City:MC KENZIE
Practice Address - State:TN
Practice Address - Zip Code:38201-1704
Practice Address - Country:US
Practice Address - Phone:407-758-6397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN83339164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse