MS. TINA WALLACE

Licensed Vocational Nurse

Active Individual
NPI: 1326484056

Practice Address

4603 40TH AVE
Kenosha, WI 53144

Phone: (262) 914-1981

Specialties

Specialty Code Primary License
Licensed Vocational Nurse 164X00000X Yes 31662-31 (WI)

Frequently Asked Questions

NPI 1326484056 is the National Provider Identifier for MS. TINA WALLACE, a Licensed Vocational Nurse provider located in Kenosha, WI. This NPI was enumerated on May 21, 2013.
MS. TINA WALLACE practices at 4603 40TH AVE, Kenosha, WI 53144.

Quick Facts

NPI
1326484056
Type
Individual
Enumerated
May 21, 2013
Last Updated
Jan 11, 2026

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