Provider Demographics
NPI:1245511146
Name:LOUIS, TAMIKA M (LPN)
Entity type:Individual
Prefix:
First Name:TAMIKA
Middle Name:M
Last Name:LOUIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 LEXINGTON SQ
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2417
Mailing Address - Country:US
Mailing Address - Phone:216-225-4767
Mailing Address - Fax:
Practice Address - Street 1:18 LEXINGTON SQ
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44143-2417
Practice Address - Country:US
Practice Address - Phone:216-225-4767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-135375-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse