Tina Marie List, LPN
Technician, Attendant Care Provider in Waucoma, IA. Individual provider (NPI-1).
NPI number1679129209
StatusActive
Last updated in NPPESAug 9, 2019
Details
- NPI
- 1679129209
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Tina Marie List
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 9, 2019
- Last updated
- Aug 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
24651 280th St.Waucoma, IA 52171
Phone 563-776-9541
Mailing address
24651 280th St.Waucoma, IA 52171
Phone 563-776-9541
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