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General NPI Number Information
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NPI Number | 1497570550
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Entity Type | Individual
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Provider Name | REBECCA TENYER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 1943 HOLLAND AVE
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City | PORT HURON
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State | MI
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Zip | 48060-1519
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Country | US
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Telephone | 810-985-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 4577 MCKINLEY RD
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City | CHINA
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State | MI
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Zip | 48054-3101
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Country | US
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Telephone | 810-278-0329
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704342734
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License Number State | MI
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