MEDICARE: MONICA L TENHUNEN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	470884	CA
2	363LG0600X	Gerontology Nurse Practitioner	185863	GA
3	363LG0600X	Gerontology Nurse Practitioner	817690	TX

General Provider Information

NPI Number	:	1275850174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA L TENHUNEN NP

Provider Business Mailing Address
First Line	:	1209 WHISPERING GLN
Second Line	:
City	:	ROYSE CITY
State	:	TX
Zip	:	75189-3742
Country	:	US
Telephone Number	:	714-357-5454
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 WHISPERING GLN
Second Line	:
City	:	ROYSE CITY
State	:	TX
Zip	:	75189-3742
Country	:	US
Telephone Number	:	714-357-5454
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2010
Last Update Date	:	05/09/2013

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