Provider Demographics
NPI:1295389567
Name:WYCHE-BROWN, TAMEKA JIMMEL (RN BSN)
Entity Type:Individual
Prefix:
First Name:TAMEKA
Middle Name:JIMMEL
Last Name:WYCHE-BROWN
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 SATTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-2718
Mailing Address - Country:US
Mailing Address - Phone:434-637-0361
Mailing Address - Fax:
Practice Address - Street 1:1302 SATTERFIELD DR
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-2718
Practice Address - Country:US
Practice Address - Phone:434-637-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001201021163WH0200X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health