Provider Demographics
NPI:1992113393
Name:VALDEZ, TAMIEKA NICOLE
Entity type:Individual
Prefix:MRS
First Name:TAMIEKA
Middle Name:NICOLE
Last Name:VALDEZ
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 1:680 RAMONA STREET
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-3246
Mailing Address - Country:US
Mailing Address - Phone:585-685-5934
Mailing Address - Fax:
Practice Address - Street 1:680 RAMONA ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-3246
Practice Address - Country:US
Practice Address - Phone:607-767-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281417164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse