Individual
MRS. CARRIE ANN TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
415 BLACK EARTH RD, WALES, WI 53183-9759
(262) 968-1876
Mailing address
478 MAJESKIE DR, PEWAUKEE, WI 53072-6533
(262) 352-2506
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
112695
WI
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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