Individual
/TIWANNA TINA COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6918 N LINCOLNSHIRE CIR, MILWAUKEE, WI 53223-6341
(414) 760-9122
Mailing address
6918 N LINCOLNSHIRE CIR, MILWAUKEE, WI 53223-6341
(414) 760-9122
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304277
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38317400
PROVIDER
WI
Enumeration date
06/04/2009
Last updated
03/03/2017
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