Individual
TAMMY JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
721 AMERICAN AVE STE 403, WAUKESHA, WI 53188-5071
(262) 549-1516
(262) 549-0648
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209005063
IL
363L00000X
Nurse Practitioner
Primary
7504
WI
Other
Enumeration date
07/19/2007
Last updated
08/22/2017
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