Individual
ANGELA TENNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 MEDICAL VILLAGE DRIVE, EDGEWOOD, KY 41017
(859) 301-2000
(859) 426-4140
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-2000
(859) 426-4140
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003096
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163925
—
OH
05
—
201359370
—
IN
05
—
78003951
—
KY
Enumeration date
01/11/2008
Last updated
08/22/2019
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