Provider Demographics
NPI:1235355777
Name:TENNANT, VERONICA EAROLYN (CNA)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:EAROLYN
Last Name:TENNANT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29TH 3RD TERRACE
Mailing Address - Street 2:APT A6
Mailing Address - City:EGG HARBOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08215
Mailing Address - Country:US
Mailing Address - Phone:609-334-5776
Mailing Address - Fax:
Practice Address - Street 1:261 CONNECTICUT DR STE 5
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4177
Practice Address - Country:US
Practice Address - Phone:800-950-6066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNA0008302441376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide