Individual
JENA B TANEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9000 W WISCONSIN AVE, DIVISION OF PEDIATRIC CARDIOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-6457
(414) 266-2294
Mailing address
9000 W WISCONSIN AVE, DIVISION OF PEDIATRIC CARDIOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-6457
(414) 266-2294
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
168287
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033499199
—
WI
Enumeration date
08/22/2011
Last updated
10/06/2014
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