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NPI Code Detail

MEDICARE: COURTNEY R TENNENT APN

MEDICARE: COURTNEY R TENNENT APN
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
1363L00000XNurse PractitionerR77367OK
2363L00000XNurse Practitioner800060TX

General Provider Information

NPI Number : 1750513024
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY R TENNENT APN
Provider Business Mailing Address
First Line : 1317 N HILLCREST
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-2091
Country : US
Telephone Number : 903-438-1110
Fax Number : 903-438-1107
Provider Business Practice Location Address
First Line : 1317 N HILLCREST
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-2091
Country : US
Telephone Number : 903-438-1110
Fax Number : 903-438-1107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2009
Last Update Date : 05/24/2013

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Directions to “ COURTNEY R TENNENT APN” Practice Location

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