Provider Demographics
NPI:1790823896
Name:TOMPKINS, CHRISTINE OLGA (RN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:OLGA
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:OLGA
Other - Last Name:TOMPKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:7480 HIGHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53129-2709
Mailing Address - Country:US
Mailing Address - Phone:414-852-4245
Mailing Address - Fax:
Practice Address - Street 1:7480 HIGHVIEW DR
Practice Address - Street 2:
Practice Address - City:GREENDALE
Practice Address - State:WI
Practice Address - Zip Code:53129-2709
Practice Address - Country:US
Practice Address - Phone:414-852-4245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI74692-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39833100Medicaid