Provider Demographics
NPI:1427832286
Name:TANCK, ALAINA MICHELLE (DNP APNP)
Entity type:Individual
Prefix:
First Name:ALAINA
Middle Name:MICHELLE
Last Name:TANCK
Suffix:
Gender:F
Credentials:DNP APNP
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:MICHELLE
Other - Last Name:SCHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3559 CREEKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-7823
Mailing Address - Country:US
Mailing Address - Phone:920-939-4512
Mailing Address - Fax:
Practice Address - Street 1:3925 N GATEWAY DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7863
Practice Address - Country:US
Practice Address - Phone:920-830-6877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1443333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily