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Individual

PAMELA L TENNANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2211
WI
367A00000X
Advanced Practice Midwife
Primary
85350
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38253900
WI
Enumeration date
06/16/2005
Last updated
03/24/2015
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