Provider Demographics
NPI:1205637436
Name:EMERY, TAMARA J (CNA)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:J
Last Name:EMERY
Suffix:
Gender:
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 TRUCIOUS PL
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-5347
Mailing Address - Country:US
Mailing Address - Phone:727-485-6769
Mailing Address - Fax:
Practice Address - Street 1:4211 TRUCIOUS PL
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-5347
Practice Address - Country:US
Practice Address - Phone:727-485-6769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1300763104A0630X, 385H00000X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No385H00000XRespite Care FacilityRespite Care