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Individual

MS. IRENE F NILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
141 S LAKESHORE DR, SEAWALL A-6, RACINE, WI 53403-9661
(262) 552-0229
Mailing address
141 S LAKESHORE DR, SEAWALL B-7, RACINE, WI 53403-9661
(262) 553-1275

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
WI
163WH0200X
Home Health Registered Nurse
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38281800
WI
Enumeration date
02/26/2007
Last updated
10/20/2007
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