Provider Demographics
NPI:1891570966
Name:EHALT, TONJA MARIE (RN)
Entity type:Individual
Prefix:
First Name:TONJA
Middle Name:MARIE
Last Name:EHALT
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 1:519 E HASELTINE ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-2509
Mailing Address - Country:US
Mailing Address - Phone:218-398-1627
Mailing Address - Fax:
Practice Address - Street 1:519 E HASELTINE ST
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-2509
Practice Address - Country:US
Practice Address - Phone:218-398-1627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI257256163WG0000X, 163WG0600X, 163WH0200X, 163WH1000X, 163WI0600X, 163WP0807X, 163WC0400X, 163WC1500X, 163WC1600X, 163WU0100X, 163WX0200X, 163WP0808X, 163WP0809X, 163WP2201X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WU0100XNursing Service ProvidersRegistered NurseUrology
No163WX0200XNursing Service ProvidersRegistered NurseOncology
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care