MEDICARE: TAMIKA WOODEN

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	163WG0000X	General Practice Registered Nurse	911377	TX

General Provider Information

NPI Number	:	1548834815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMIKA WOODEN

Provider Business Mailing Address
First Line	:	12975 MICHELLE DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-2354
Country	:	US
Telephone Number	:	901-859-3851
Fax Number	:

Provider Business Practice Location Address
First Line	:	7557 RAMBLER RD STE 225
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2303
Country	:	US
Telephone Number	:	901-859-3851
Fax Number	:

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

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	05/19/2021

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Directions to “ TAMIKA WOODEN ” Practice Location

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