National Provider Identifier
Tamika Shawntrice Petty, LPN
Tamika Shawntrice Petty, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Buffalo, NY and a listed phone number of (716) 247-1481.
Profile Overview
- NPI
- 1205202207
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- August 13, 2015
- Last Updated
- August 13, 2015
Practice Location
- 189 Brunswick Blvd
- 2
- Buffalo, NY 14208-1622
Phone: (716) 247-1481
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1205202207
- Entity Type
- Individual
- Last Name
- Petty
- First Name
- Tamika
- Middle Name
- Shawntrice
- Name Prefix
- Mrs.
- Credential
- LPN
- Provider Other Last Name
- Newell
- Provider Other First Name
- Tamika
- Provider Other Middle Name
- Shawntrice
- Provider Other Credential Text
- LPN
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 189 Brunswick Blvd
- Mailing Address Line 2
- 2
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14208-1622
- Mailing Country
- US
- Mailing Phone
- (716) 247-1481
- Practice Street Address
- 189 Brunswick Blvd
- Practice Address Line 2
- 2
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14208-1622
- Practice Country
- US
- Practice Phone
- (716) 247-1481
- Enumeration Date
- August 13, 2015
- Last Updated
- August 13, 2015
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)