Provider Demographics
NPI:1003574088
Name:4 LESS PNCC LEARNING AND TRAINING ACADEMY
Entity Type:Organization
Organization Name:4 LESS PNCC LEARNING AND TRAINING ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LARUTHIEA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-899-3638
Mailing Address - Street 1:4163 N 72ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1035
Mailing Address - Country:US
Mailing Address - Phone:414-899-3638
Mailing Address - Fax:414-585-9272
Practice Address - Street 1:4163 N 72ND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-1035
Practice Address - Country:US
Practice Address - Phone:414-899-3638
Practice Address - Fax:414-585-9272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatalGroup - Multi-Specialty