Provider Demographics
NPI:1710542410
Name:TENHUNDFELD, KEITH PETER (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:PETER
Last Name:TENHUNDFELD
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7995 NEW HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-9738
Mailing Address - Country:US
Mailing Address - Phone:513-401-3646
Mailing Address - Fax:
Practice Address - Street 1:7995 NEW HAVEN RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-9738
Practice Address - Country:US
Practice Address - Phone:513-401-3646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLE-00027396363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily