Provider Demographics
NPI:1215810551
Name:MCWILLIAMS, TAMICA ROSHAWN
Entity type:Individual
Prefix:
First Name:TAMICA
Middle Name:ROSHAWN
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 E FLAMINGO RD STE H
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5208
Mailing Address - Country:US
Mailing Address - Phone:725-251-3854
Mailing Address - Fax:
Practice Address - Street 1:108 BRIELLE BEACON LN
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-5707
Practice Address - Country:US
Practice Address - Phone:813-499-4270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5244565164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse