Provider Demographics
NPI:1710038443
Name:TENNYSON, COLLEEN G (MD)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:G
Last Name:TENNYSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:80 BLUESTONE DR
Mailing Address - Street 2:MSC 0801
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22807-1023
Mailing Address - Country:US
Mailing Address - Phone:540-568-6552
Mailing Address - Fax:540-568-8096
Practice Address - Street 1:80 BLUESTONE DR
Practice Address - Street 2:MSC 0801
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807-1023
Practice Address - Country:US
Practice Address - Phone:540-568-6552
Practice Address - Fax:540-568-8096
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2012-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012403022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry