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NPI Code Detail

MEDICARE: TAMMY RENEE VIRGIL RN

MEDICARE:   TAMMY RENEE VIRGIL  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseWI

General Provider Information

NPI Number : 1821058918
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY RENEE VIRGIL RN
Provider Business Mailing Address
First Line : 4332 N 38TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-1728
Country : US
Telephone Number : 414-871-2643
Fax Number :
Provider Business Practice Location Address
First Line : 4332 N 38TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-1728
Country : US
Telephone Number : 414-871-2643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 07/08/2007

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Directions to “ TAMMY RENEE VIRGIL RN” Practice Location

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