Healthcare Provider Details

I. General information

NPI: 1003528084
Provider Name (Legal Business Name): LOBSANG TENZING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 12/21/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WILLIAM S MIDDLETON HOSPITAL 2500 OVERLOOK TERRACE
MADISON WI
53705-2286
US

IV. Provider business mailing address

1213 MEADOW SWEET DR
MADISON WI
53719-4516
US

V. Phone/Fax

Practice location:
  • Phone: 608-256-1901
  • Fax:
Mailing address:
  • Phone: 608-829-1037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number140267
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number140267
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: