Provider Demographics
NPI:1265813794
Name:TETZNER, DENISE (FNPC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:TETZNER
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 472
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958
Mailing Address - Country:US
Mailing Address - Phone:302-645-6698
Mailing Address - Fax:302-645-4505
Practice Address - Street 1:1309 SAVANNAH RD STE B
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-645-6698
Practice Address - Fax:302-645-4505
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000798363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner