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NPI Code Detail

MEDICARE: MR. ROSS ANDREW TENNANT III APRN

MEDICARE: MR. ROSS ANDREW TENNANT III APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN67041WV
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1548549660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROSS ANDREW TENNANT III APRN
Provider Business Mailing Address
First Line : PO BOX 644118
Second Line :
City : PITTSBURGH
State : PA
Zip : 15264-4118
Country : US
Telephone Number : 304-243-3070
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL PARK
Second Line :
City : WHEELING
State : WV
Zip : 26003-6300
Country : US
Telephone Number : 304-243-3000
Fax Number : 304-243-3060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2011
Last Update Date : 02/19/2026

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