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Individual

TAMEKA ROMAN IRVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6012
(864) 560-6013
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
19151
SC
364S00000X
Clinical Nurse Specialist
19151
SC
364SA2200X
Adult Health Clinical Nurse Specialist
19151
SC
364SA2200X
Adult Health Clinical Nurse Specialist
CNS-00255
NM
364SG0600X
Gerontology Clinical Nurse Specialist
19151
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP3016
SC
01
SC48035019
MEDICARE PIN
SC
Enumeration date
11/18/2014
Last updated
04/25/2022
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