Provider Demographics
NPI:1154472264
Name:TENEZA, WENDY OLIVIA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:OLIVIA
Last Name:TENEZA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 W WILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85009-2805
Mailing Address - Country:US
Mailing Address - Phone:602-377-9960
Mailing Address - Fax:602-234-0606
Practice Address - Street 1:2800 N 44TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-1500
Practice Address - Country:US
Practice Address - Phone:602-377-9960
Practice Address - Fax:602-234-0606
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ114741163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care