Individual
MISS TANIA SHERI MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
2647 N HOLTON ST, MILWAUKEE, WI 53212-2928
(141) 265-5113
Mailing address
2647 N HOLTON ST, MILWAUKEE, WI 53212-2928
(141) 265-5113
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
125198030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39991400
—
WI
Enumeration date
05/03/2006
Last updated
05/29/2008
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