Individual
TAMARA LYNN HULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3072 PROVIDENCE ST, SUN PRAIRIE, WI 53590-4585
(608) 556-6490
Mailing address
3072 PROVIDENCE ST, SUN PRAIRIE, WI 53590-4585
(608) 556-6490
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
308161-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
308161-31
LPN LICENSE #
WI
Enumeration date
03/07/2018
Last updated
06/16/2018
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