Healthcare Provider Details

I. General information

NPI: 1922770858
Provider Name (Legal Business Name): ARIELLE M TENOR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARIELLE M TREMEL NP

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 DEWEY ST
MANITOWOC WI
54220-5813
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 920-686-5731
  • Fax: 920-686-5726
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11224
License Number StateWI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier100183507
Identifier TypeMEDICAID
Identifier StateWI
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: