Provider Demographics
NPI:1790107084
Name:MEREDITH-WILLIAMS, TAMIKA
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:
Last Name:MEREDITH-WILLIAMS
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 1:19630 EUCLID AVE
Mailing Address - Street 2:APT 305
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1465
Mailing Address - Country:US
Mailing Address - Phone:216-268-9814
Mailing Address - Fax:
Practice Address - Street 1:19630 EUCLID AVE
Practice Address - Street 2:305
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1465
Practice Address - Country:US
Practice Address - Phone:216-268-9814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH375626380596376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide