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Individual

MR. JACOB ADAM TANEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APNP

Contact information

Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 385-1922
Mailing address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 385-1922

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7892
WI
363LA2100X
Acute Care Nurse Practitioner
7892-33
WI

Other

Enumeration date
08/14/2017
Last updated
07/21/2022
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