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Individual

NICHOLAS A. TENNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3433 ALGIERS DR APT 2192, LAS VEGAS, NV 89115-2848
(702) 823-6207
Mailing address
PO BOX 570892, LAS VEGAS, NV 89157-0892
(323) 487-1652

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
246ZS0410X
Surgical Technologist
171363
CA
246ZS0410X
Surgical Technologist
Primary
171363

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
171363
NBSTSA
Enumeration date
02/15/2016
Last updated
01/17/2023
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