Provider Demographics
NPI:1841558277
Name:AMAN, REESE TARIK (RN)
Entity Type:Individual
Prefix:
First Name:REESE
Middle Name:TARIK
Last Name:AMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716A S HERMAN ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-3903
Mailing Address - Country:US
Mailing Address - Phone:414-313-4445
Mailing Address - Fax:
Practice Address - Street 1:3716A S HERMAN ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-3903
Practice Address - Country:US
Practice Address - Phone:414-313-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI166731-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse