Tilly, Jane B
Tilly, Jane B is an sole proprietor health care provider with primary practice located at 770 Pennsylvania Ave , West Bend WI 53095-4142. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Tilly, Jane B can be contacted via phone (262) 339-4752.Contact Information
Primary practice address
770 Pennsylvania Ave
West Bend WI 53095-4142
Phone: (262) 339-4752
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Registered Nurse | 163W00000X | 78518-030 | Wisconsin |
Profile Details
NPI number | 1609827690 |
---|---|
LBN Legal business name | Tilly, Jane B |
Credentials | Registered Nurse (RN) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 13th, 2006 |
Last updated | Feb 23rd, 2009 - about 15 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1609827690 | NPPES |
Wisconsin | MEDICAID | 39930300 |
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