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NPI Code Detail

MEDICARE: TENNEY THOMAS RN,PHN

MEDICARE: TENNEY THOMAS RN,PHN
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
1163WM0102XMaternal Newborn Registered Nurse166473CO
2163W00000XRegistered NurseRN0166473CO
3163W00000XRegistered Nurse556787CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780717553
Entity Type Code : Individual
Provider Name (Legal Business Name) : TENNEY THOMAS RN,PHN
Provider Business Mailing Address
First Line : 321 CASSIDY ST
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-5314
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 321 CASSIDY ST
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-5314
Country : US
Telephone Number : 760-721-2171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 12/14/2016

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