Provider Demographics
NPI:1164190286
Name:FETNER, MARGUERITE ZAYAS (DNP, AGACNP-BC, APRN)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:ZAYAS
Last Name:FETNER
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ROCHELLE AVE
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-9619
Mailing Address - Country:US
Mailing Address - Phone:615-987-5956
Mailing Address - Fax:
Practice Address - Street 1:1000 ROCHELLE AVE
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-9619
Practice Address - Country:US
Practice Address - Phone:615-987-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28386363L00000X, 363LA2200X
TN28326363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health