Provider Demographics
NPI:1134690035
Name:DALKA, ANNETTE LYNN
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:LYNN
Last Name:DALKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W1254 COUNTY ROAD A
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-9002
Mailing Address - Country:US
Mailing Address - Phone:715-490-9293
Mailing Address - Fax:
Practice Address - Street 1:W1254 COUNTY ROAD A
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-9002
Practice Address - Country:US
Practice Address - Phone:715-490-9293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI87410163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse