Provider Demographics
NPI:1457509937
Name:CONNER, TAMIKA MONIQUE
Entity Type:Individual
Prefix:MRS
First Name:TAMIKA
Middle Name:MONIQUE
Last Name:CONNER
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 1:2414 N 57TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66104-2813
Mailing Address - Country:US
Mailing Address - Phone:816-564-2940
Mailing Address - Fax:
Practice Address - Street 1:2414 N 57TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66104-2813
Practice Address - Country:US
Practice Address - Phone:816-564-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)