National Provider Identifier

Shalom Tahnee Wilson, LPN

Shalom Tahnee Wilson, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 329-4306.

NPI 1659900611Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1659900611
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
April 02, 2020
Last Updated
April 02, 2020

Practice Location

  • Shalomwilson36@Gmail.Com
  • 118 Pine Street
  • Rochester, NY 14445

Phone: (585) 329-4306

Mailing Address

  • Shalom Wilson
  • 118 Pine Street
  • Rochester, NY 14445

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1659900611
Entity Type
Individual
Last Name
Wilson
First Name
Shalom
Middle Name
Tahnee
Name Prefix
Mr.
Credential
LPN
Mailing Street Address
Shalom Wilson
Mailing Address Line 2
118 Pine Street
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14445
Mailing Country
US
Mailing Phone
(585) 329-4306
Practice Street Address
Shalomwilson36@Gmail.Com
Practice Address Line 2
118 Pine Street
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14445
Practice Country
US
Practice Phone
(585) 329-4306
Enumeration Date
April 02, 2020
Last Updated
April 02, 2020
Sex
Male
Sole Proprietor
Yes
Certification Date
April 02, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)