Provider Demographics
NPI:1659674588
Name:TENNIHAN, DINEEN MARY (RN)
Entity Type:Individual
Prefix:MRS
First Name:DINEEN
Middle Name:MARY
Last Name:TENNIHAN
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 1:236 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1495
Mailing Address - Country:US
Mailing Address - Phone:617-591-4369
Mailing Address - Fax:617-591-4340
Practice Address - Street 1:236 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1495
Practice Address - Country:US
Practice Address - Phone:617-591-4369
Practice Address - Fax:617-591-4340
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176928163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse