Provider Demographics
NPI:1356189732
Name:KARLS, TINA (RN)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:KARLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16928 LAX CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-3128
Mailing Address - Country:US
Mailing Address - Phone:920-960-8462
Mailing Address - Fax:
Practice Address - Street 1:16928 LAX CHAPEL RD
Practice Address - Street 2:
Practice Address - City:KIEL
Practice Address - State:WI
Practice Address - Zip Code:53042-3128
Practice Address - Country:US
Practice Address - Phone:920-960-8462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI157695-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse