Individual
MICHAEL TENNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 742-4131
(608) 745-5161
Mailing address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 617-2506
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
132225-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054407
CRNA RECERTIFICATION CARD
—
05
—
4432000
—
WI
Enumeration date
12/15/2005
Last updated
11/17/2022
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