Doctor Name: | RYAN TENN |
NPI Number: | 1013388735 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | AGCNP, APRN-RX |
License Number: | APRN-1985 |
Business Practice Address: | 55-510 Kamehameha Hwy Laie, HI - 967621138 |
Business Phone Number: | 8082938558 |
Business Fax Number: | |
Mailing Address: | 55-510 Kamehameha Hwy, LAIE |
State: | HI |
Postal Code: | 967621138 |
Phone Number: | 8082938558 |
Fax Number: | |
NPI Enumeration Date: | 10/08/2015 |
NPI Last Update Date: | 01/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | APRN-1985 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | HI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |