Provider Demographics
NPI:1164022794
Name:TENOLD, LAUREN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:TENOLD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8913 W 131ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-3607
Mailing Address - Country:US
Mailing Address - Phone:913-575-8198
Mailing Address - Fax:
Practice Address - Street 1:8913 W 131ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-3607
Practice Address - Country:US
Practice Address - Phone:913-575-8195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-105889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist