Provider Demographics
NPI:1275264525
Name:MELLS, TEKIRA
Entity Type:Individual
Prefix:
First Name:TEKIRA
Middle Name:
Last Name:MELLS
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 1:5115 N SOCRUM LOOP RD APT 72
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-4214
Mailing Address - Country:US
Mailing Address - Phone:863-999-2727
Mailing Address - Fax:
Practice Address - Street 1:5115 N SOCRUM LOOP RD APT 72
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-4214
Practice Address - Country:US
Practice Address - Phone:863-999-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula