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General NPI Number Information
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NPI Number | 1477179307
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Entity Type | Individual
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Provider Name | IKAMIE TAFT
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Gender | Female
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Dates
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Enumeration Date | 06/16/2020
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 3280 CHARLES BLVD STE 306
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City | GREENVILLE
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State | NC
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Zip | 27858-8875
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Country | US
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Telephone | 252-702-6218
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | WINTERVILLE
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State | NC
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Zip | 28590-0699
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Country | US
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Telephone | 252-341-9572
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HC5500
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License Number State | NC
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