Provider Demographics
NPI:1295017556
Name:TENY, AMOIN MARIE BERTHE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:AMOIN MARIE
Middle Name:BERTHE
Last Name:TENY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 S PARK ST APT 16
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-1937
Mailing Address - Country:US
Mailing Address - Phone:608-669-5679
Mailing Address - Fax:
Practice Address - Street 1:2309 S PARK ST APT 16
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-1937
Practice Address - Country:US
Practice Address - Phone:608-669-5679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI313882-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse