Individual
TENDRA MONIQUE TOLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2936 N 53RD ST, MILWAUKEE, WI 53210-1615
(414) 982-7197
Mailing address
2936 N 53RD ST, MILWAUKEE, WI 53210-1615
(414) 982-7197
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304311-031
WI
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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