Provider Demographics
NPI:1386877975
Name:WHITE, TREANACE (RN)
Entity type:Individual
Prefix:
First Name:TREANACE
Middle Name:
Last Name:WHITE
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 1:5443 N 92ND ST UNIT D
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-3490
Mailing Address - Country:US
Mailing Address - Phone:414-416-6794
Mailing Address - Fax:
Practice Address - Street 1:5443 N 92ND ST UNIT D
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-3490
Practice Address - Country:US
Practice Address - Phone:414-416-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164144-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse