Healthcare Provider Details

I. General information

NPI: 1326983081
Provider Name (Legal Business Name): TENEE' LASHEE' MARTIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 QUEENS CIR
LAURENS SC
29360-3833
US

IV. Provider business mailing address

166 QUEENS CIR
LAURENS SC
29360-3833
US

V. Phone/Fax

Practice location:
  • Phone: 864-981-1629
  • Fax: 864-981-1629
Mailing address:
  • Phone: 864-981-1629
  • Fax: 864-981-1629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026016805
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: