Individual
TYRANT THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
5541 N 42ND ST, MILWAUKEE, WI 53209-4628
(414) 699-9035
Mailing address
5541 N 42ND ST, MILWAUKEE, WI 53209-4628
(414) 699-9035
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
122003-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39985000
—
WI
Enumeration date
06/24/2009
Last updated
06/24/2009
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