Teshama Nichole Brock, R.N.

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

RN60174365 Issued in WA

Practice address

1313 Broadway
Tacoma, WA 98402-3400

Phone

(253) 209-4591

NPI assigned

Apr 13, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Miss Teshama Nichole Bouie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1497071658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18208 SE 246TH ST",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424853",
            "telephone_number": "253-209-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 BROADWAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023400",
            "telephone_number": "253-209-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "TESHAMA",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200942602RN",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 9291520",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WA",
            "license": "RN60174365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TESHAMA",
            "last_name": "BOUIE",
            "middle_name": "NICHOLE",
            "prefix": "MISS",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bridgette Brittain
• Mark Aaron Broadbent, MD
• Mary Broadbent, RN
• Savannah Martha Broadlick, DO
• Danielle Broberg, OTR/L
• Diana Brockett
• Cory Brockman
• Daniel Brocksmith, PA-C
• April Samone Brodahl, SLPA
• Julie Broderson-Quitugua, RN

• Home Health Registered Nurse in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Home Health Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.