Ms Tina Wallace, - Licensed Vocational Nurse in Kenosha, WI

Ms Tina Wallace, is a Licensed Vocational Nurse based in Kenosha, Wisconsin. Ms Tina Wallace is licensed to practice in Wisconsin (license number 31662-31) and her current practice location is 4603 40th Ave, Kenosha, Wisconsin. She can be reached at her office (for appointments etc.) via phone at (262) 914-1981.

NPI number for Ms Tina Wallace is 1326484056 and her current mailing address is 4603 40th Ave, Kenosha, Wisconsin. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1326484056.

Contact Information

Ms Tina Wallace,
4603 40th Ave,
Kenosha, WI 53144-3543
(262) 914-1981
Not Available



Provider's Profile

Full NameMs Tina Wallace
GenderFemale
SpecialityLicensed Vocational Nurse
Location4603 40th Ave, Kenosha, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1326484056
  • Provider Enumeration Date: 05/21/2013
  • Last Update Date: 05/21/2013

Medical Identifiers

Medical identifiers for Ms Tina Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1326484056NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
164X00000XLicensed Vocational Nurse 31662-31 (Wisconsin)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Tina Wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Tina Wallace,
4603 40th Ave,
Kenosha, WI 53144-3543

Ph: (262) 914-1981
Ms Tina Wallace,
4603 40th Ave,
Kenosha, WI 53144-3543

Ph: (262) 914-1981

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Licensed Vocational Nurse Nurses in Kenosha, WI

Mary Susan Bernardy, LVN
Licensed Vocational Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 8207 22nd Ave, Kenosha, WI 53143
Phone: 224-610-8902    

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