Provider Demographics
NPI:1043891112
Name:ADAMS, TOMESHA (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:TOMESHA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-3703
Mailing Address - Country:US
Mailing Address - Phone:229-473-0528
Mailing Address - Fax:
Practice Address - Street 1:205 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-3703
Practice Address - Country:US
Practice Address - Phone:229-473-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030012170374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide