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Organization

NURSEGENICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS AUDRYUNNA TAHQWELA TATE LPN (OWNER)
(414) 982-8738
Entity
Organization

Contact information

Practice address
2363 S 102ND ST STE 202, WEST ALLIS, WI 53227-2143
(262) 417-1195
Mailing address
2363 S 102ND ST STE 202, WEST ALLIS, WI 53227-2143
(262) 417-1195

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
164W00000X
Licensed Practical Nurse
246RP1900X
Phlebotomy Technician
251J00000X
Nursing Care Agency
253Z00000X
In Home Supportive Care Agency
261QH0100X
Health Service Clinic/Center
Primary
372600000X
Adult Companion
374U00000X
Home Health Aide

Other

Enumeration date
05/02/2024
Last updated
05/02/2024
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