Provider Demographics
NPI:1912214131
Name:RANKIN, TAMIEKA SHANNELL
Entity Type:Individual
Prefix:
First Name:TAMIEKA
Middle Name:SHANNELL
Last Name:RANKIN
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 1:2133 BURTON RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:HIGHPOINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-8084
Mailing Address - Country:US
Mailing Address - Phone:336-402-8774
Mailing Address - Fax:
Practice Address - Street 1:2133 BURTON RUN ROAD
Practice Address - Street 2:
Practice Address - City:HIGHPOINT
Practice Address - State:NC
Practice Address - Zip Code:27262-8084
Practice Address - Country:US
Practice Address - Phone:336-402-8774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC265670376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide