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Individual

MISS TAMARA J VAN LANNEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(414) 246-6400
(414) 246-6405
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 246-6400

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
163165-30
WI
363L00000X
Nurse Practitioner
Primary
5880
WI
363LF0000X
Family Nurse Practitioner
5880-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100040042
WI
Enumeration date
03/05/2010
Last updated
07/18/2022
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