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General NPI Number Information
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NPI Number | 1295764603
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Entity Type | Individual
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Provider Name | PATRICIA E TENNANT CNP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 1900 23RD ST
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44223-1404
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Country | US
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Telephone | 330-971-7221
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Fax |
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Provider Business Mailing Address
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Address Line | 440 WYOGA LAKE BLVD
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44224-1137
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Country | US
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Telephone | 330-920-1052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP07763
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License Number State | OH
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