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Individual

TAMIKA NICOLE PRATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
141 OLD ORANGE PARK RD APT 141, ORANGE PARK, FL 32073-3012
(904) 589-0735
Mailing address
141 OLD ORANGE PARK RD APT 141, ORANGE PARK, FL 32073-3012
(904) 589-0735

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
CNA390774
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P15722266
STATE OF KENTUCKY
KY
Enumeration date
08/05/2020
Last updated
08/05/2020
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