Provider Demographics
NPI:1952066417
Name:WILKERSON, TAMECA A (CNA)
Entity Type:Individual
Prefix:
First Name:TAMECA
Middle Name:A
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7252 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-3734
Mailing Address - Country:US
Mailing Address - Phone:804-304-8286
Mailing Address - Fax:
Practice Address - Street 1:7252 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3734
Practice Address - Country:US
Practice Address - Phone:804-304-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401134529376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide