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Individual

ELLEN THALACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
340 FAIR ST, EVANSVILLE, WI 53536-1361
(608) 882-5224
Mailing address
340 FAIR ST, EVANSVILLE, WI 53536-1361

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
23705630
WI

Other

Enumeration date
05/20/2026
Last updated
05/20/2026
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