Provider Demographics
NPI:1518164466
Name:DZIENNY, TINA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:DZIENNY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7081 S WINNERS CIR
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-4500
Mailing Address - Country:US
Mailing Address - Phone:419-276-9122
Mailing Address - Fax:
Practice Address - Street 1:1900 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4500
Practice Address - Country:US
Practice Address - Phone:419-276-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704247053163W00000X
OH312565163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse