Individual
TAHNEE SIEWERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 320-4660
Mailing address
4540 S 16TH ST, SHEBOYGAN, WI 53081-7718
(920) 634-9393
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
175038-30
WI
363LG0600X
Gerontology Nurse Practitioner
Primary
5173-33
WI
Other
Enumeration date
08/27/2012
Last updated
08/12/2015
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