Provider Demographics
NPI:1881203610
Name:STEELE, TEKISHA S (NURSING ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:TEKISHA
Middle Name:S
Last Name:STEELE
Suffix:
Gender:F
Credentials:NURSING ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 LEMOYNE LANE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505
Mailing Address - Country:US
Mailing Address - Phone:850-288-3106
Mailing Address - Fax:
Practice Address - Street 1:4503 LEMOYNE LANE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505
Practice Address - Country:US
Practice Address - Phone:850-288-3106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225976376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS8408179630OtherS8408179630