Tyler Fanta, RN
NPI #1518404391 in Cottage Grove, Wisconsin
Provider Information
- NPI Number
- 1518404391
- Entity Type
- Individual
- Name
- Tyler Fanta, RN
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Registered Nurse
- Credential
- RN
- Enumeration Date
- Jan 31, 2017
- Last Updated
- Jan 31, 2017
Practice Location
- Address
- 212 WEALD BRIDGE RD
- City
- Cottage Grove
- State
- Wisconsin
- ZIP Code
- 53527-9363
- Phone
- (608) 317-2830
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse |
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