Tallen-Whited, Aemelia Anne

Tallen-Whited, Aemelia Anne is an individual health care provider with primary practice located at 6308 8Th Ave Suite 1040, Kenosha WI 53143-5031. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Tallen-Whited, Aemelia Anne can be contacted via phone (262) 653-5437.

Contact Information

Primary practice address
6308 8Th Ave Suite 1040 Kenosha WI 53143-5031
Phone: (262) 653-5437
Fax: (262) 656-3415
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 4695-33 Wisconsin

Profile Details

NPI number 1831402734
LBN Legal business name Tallen-Whited, Aemelia Anne
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2010
Last updated Mar 4th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831402734 NPPES
Wisconsin Other 4695-33 LICENSE
Wisconsin MEDICAID 1831402734 LICENSE

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