Provider Demographics
NPI:1366973364
Name:NEVILLE, TAMEKA R (FNP)
Entity type:Individual
Prefix:MS
First Name:TAMEKA
Middle Name:R
Last Name:NEVILLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 CARTIER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-1804
Mailing Address - Country:US
Mailing Address - Phone:504-322-0959
Mailing Address - Fax:
Practice Address - Street 1:600 W HILLSBORO BLVD STE 10
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1609
Practice Address - Country:US
Practice Address - Phone:186-644-8771
Practice Address - Fax:954-596-4746
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09237363LF0000X
TX132823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily