Wallace, Tina

Wallace, Tina is an sole proprietor health care provider with primary practice located at 4603 40Th Ave , Kenosha WI 53144-3543. She recently has only one registered license in Nursing Service Providers / Licensed Vocational Nurse, which is considered as her primary health care specialty. Wallace, Tina can be contacted via phone (262) 914-1981.

Contact Information

Primary practice address
4603 40Th Ave Kenosha WI 53144-3543
Phone: (262) 914-1981
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Vocational Nurse 164X00000X 31662-31 Wisconsin

Profile Details

NPI number 1326484056
LBN Legal business name Wallace, Tina
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 21st, 2013
Last updated May 21st, 2013 - about 12 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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