Provider Demographics
NPI:1932429578
Name:WELLINGTON, TAMEIKA L (RN)
Entity Type:Individual
Prefix:
First Name:TAMEIKA
Middle Name:L
Last Name:WELLINGTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TAMEIKA
Other - Middle Name:L
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:120 ALCOTT PL APT 6E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4229
Mailing Address - Country:US
Mailing Address - Phone:347-257-5346
Mailing Address - Fax:
Practice Address - Street 1:120 ALCOTT PL APT 6E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4229
Practice Address - Country:US
Practice Address - Phone:347-257-5346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-06
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY647997163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health