Provider Demographics
NPI:1275826752
Name:TENORIO, DORENE RENEE (LPN)
Entity Type:Individual
Prefix:
First Name:DORENE
Middle Name:RENEE
Last Name:TENORIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5058 TROY RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-8126
Mailing Address - Country:US
Mailing Address - Phone:397-450-8055
Mailing Address - Fax:
Practice Address - Street 1:5058 TROY RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502-8126
Practice Address - Country:US
Practice Address - Phone:397-450-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.106948164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse