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Individual

KAITLIN TENNYSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1301 W 12TH AVE STE 301, EMPORIA, KS 66801-2590
(620) 343-2376
(620) 343-5987
Mailing address
1201 W 12TH AVE, EMPORIA, KS 66801-2504
(620) 343-6800
(620) 341-7821

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0446933
KS
207Q00000X
Family Medicine Physician
TL0007768
CO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/30/2019
Last updated
11/02/2022
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