Individual
TENNEH MOIBAH SOKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1649 VERNON ST, #4, STOUGHTON, WI 53589-2277
(608) 873-6835
Mailing address
3650 BRECKENRIDGE CT APT 16, FITCHBURG, WI 53713-3655
(608) 271-0514
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38338800
PROVIDER #
WI
Enumeration date
03/30/2007
Last updated
07/08/2007
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