Individual ProviderTanya WollnerNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2801 W Kinnickinnic River Pkwy, #525, Milwaukee, WI 53215(414) 385-2550(414) 649-3240PECOS EnrollmentBased on the most recent information from CMS, provider Tanya Wollner is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1093822975Provider TypeIndividualFull NameWollner, TanyaTitleMs.CredentialAPNPGenderFemaleSole ProprietorNoEnumeration Date8/24/2006Last Updated11/10/2023Contact InformationPractice LocationPractice Address2801 W Kinnickinnic River Pkwy, #525, Milwaukee, WI 53215Phone(414) 385-2550Fax(414) 649-5414Mailing LocationMailing AddressPO Box 735044, Chicago, IL 60673-5044Phone(414) 649-3240FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2300-033WisconsinCode363L00000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense129052-030WisconsinProvider IdentifiersIDDescriptionIssuerID41181700DescriptionMedicaidIssuerUnlistedWisconsin