Provider Demographics
NPI:1245615558
Name:PAKULSKI, TANYA (APNP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:PAKULSKI
Suffix:
Gender:F
Credentials:APNP
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Other - Last Name:
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Mailing Address - Street 1:2901 W KINNICKINNIC RIVER PKWY
Mailing Address - Street 2:SUITE 315
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3677
Mailing Address - Country:US
Mailing Address - Phone:414-649-5646
Mailing Address - Fax:414-649-6282
Practice Address - Street 1:2901 W KINNICKINNIC RIVER PKWY
Practice Address - Street 2:SUITE 315
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3677
Practice Address - Country:US
Practice Address - Phone:414-649-5646
Practice Address - Fax:414-649-6282
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI6505-33363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care