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NPI Code Detail

MEDICARE: NICHOLAS A. TENNEY

MEDICARE:   NICHOLAS A. TENNEY
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
1246ZS0410XSurgical Technologist171363CA
2246ZC0007XSurgical Assistant
3246ZS0410XSurgical Technologist171363

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1171363OTHERNBSTSA

General Provider Information

NPI Number : 1932568391
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS A. TENNEY
Provider Business Mailing Address
First Line : PO BOX 570892
Second Line :
City : LAS VEGAS
State : NV
Zip : 89157-0892
Country : US
Telephone Number : 323-487-1652
Fax Number :
Provider Business Practice Location Address
First Line : 3433 ALGIERS DR APT 2192
Second Line :
City : LAS VEGAS
State : NV
Zip : 89115-2848
Country : US
Telephone Number : 702-823-6207
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2016
Last Update Date : 01/17/2023

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Directions to “ NICHOLAS A. TENNEY ” Practice Location

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