Provider Demographics
NPI:1811714074
Name:THOMPSON, TAMEKA JOY (LPN)
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:JOY
Last Name:THOMPSON
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 1:3418 WAYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-3061
Mailing Address - Country:US
Mailing Address - Phone:330-301-6773
Mailing Address - Fax:
Practice Address - Street 1:3418 WAYSIDE DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-3061
Practice Address - Country:US
Practice Address - Phone:330-301-6773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.159908.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse