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Individual
DR. BRENDAN GORDON TENNEFOSS
Active
Individual
DR. BRENDAN GORDON TENNEFOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, AGPCNP, ACHPN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201708761RN
OR
163W00000X
Registered Nurse
65076
ID
163W00000X
Registered Nurse
RN60800461
WA
363L00000X
Nurse Practitioner
201709029NP-PP
OR
363L00000X
Nurse Practitioner
Primary
AP61074323
WA
363LA2200X
Adult Health Nurse Practitioner
201709029NP-PP
OR
363LP2300X
Primary Care Nurse Practitioner
65076
ID
Other
Enumeration date
11/06/2017
Last updated
10/19/2021
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