MEDICARE: MRS. TAMEIKA MEICHELL WARE R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN368123	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN368123	OTHER	OH	OHIO BOARD OF NURSING

General Provider Information

NPI Number	:	1962834465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMEIKA MEICHELL WARE R.N.

Provider Business Mailing Address
First Line	:	3629 INGLESIDE RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-5003
Country	:	US
Telephone Number	:	216-322-5351
Fax Number	:

Provider Business Practice Location Address
First Line	:	3629 INGLESIDE RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-5003
Country	:	US
Telephone Number	:	216-322-5351
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2013
Last Update Date	:	08/07/2013

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