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NPI Code Detail

MEDICARE: TAMIKA JENNINGS

MEDICARE:   TAMIKA  JENNINGS
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
1172V00000XCommunity Health Worker
2376G00000XNursing Home Administrator
3106S00000XBehavior TechnicianMI
4251E00000XHome Health AgencyMI
5374U00000XHome Health Aide
63747P1801XPersonal Care AttendantMI

Other Identifiers

General Provider Information

NPI Number : 1568290674
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMIKA JENNINGS
Provider Business Mailing Address
First Line : 41800 HAYES RD STE 212
Second Line :
City : CLINTON TWP
State : MI
Zip : 48038-1876
Country : US
Telephone Number : 586-530-6950
Fax Number :
Provider Business Practice Location Address
First Line : 41800 HAYES RD STE 212
Second Line :
City : CLINTON TWP
State : MI
Zip : 48038-1876
Country : US
Telephone Number : 586-530-6950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2024
Last Update Date : 06/02/2026

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Directions to “ TAMIKA JENNINGS ” Practice Location

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