Provider Demographics
NPI:1831990654
Name:THOMAS, TAMIKO LYNN
Entity type:Individual
Prefix:
First Name:TAMIKO
Middle Name:LYNN
Last Name:THOMAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:TAMIKO
Other - Middle Name:LYNN
Other - Last Name:HARDNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1321 S 169TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1008
Mailing Address - Country:US
Mailing Address - Phone:402-881-5834
Mailing Address - Fax:
Practice Address - Street 1:1321 S 169TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-1008
Practice Address - Country:US
Practice Address - Phone:402-882-5834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19245164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse