Doctor Name: | MRS. NANCY NANETTE TIENHAARA |
NPI Number: | 1184664682 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S, ATC L, EMT |
License Number: | AL1661 |
Business Practice Address: | 4850 W Oakland Park Blvd Lauderdale Lakes, FL - 333137268 |
Business Phone Number: | 9547317440 |
Business Fax Number: | 9547317675 |
Mailing Address: | 9340 Nw 33rd Pl, SUNRISE |
State: | FL |
Postal Code: | 333517123 |
Phone Number: | 9547478680 |
Fax Number: | |
NPI Enumeration Date: | 06/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | AL1661 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |