Tamiko Johns, LPN

Individual provider Active NPI Licensed Practical Nurse · MC Kenzie, TN

NPI 1992107213 · NPPES record last updated Sep 17, 2014

Key facts

NPI
1992107213
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
83339 (TN)
Practice address
136 Carroll St
MC Kenzie, TN 38201-1704
Phone
(407) 758-6397
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
83339TNMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 83339 TN Yes

Addresses

Primary practice location

136 Carroll St
MC Kenzie, TN 38201-1704

Mailing address

136 Carroll St
MC Kenzie, TN 38201-1704
Phone (407) 758-6397

Other providers in MC Kenzie, TN

All providers in MC Kenzie, TN · Licensed Practical Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.