Provider Demographics
NPI:1720707953
Name:BARRETT, TENISHA (LPN)
Entity Type:Individual
Prefix:
First Name:TENISHA
Middle Name:
Last Name:BARRETT
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 1:22 GENEVA CT APT C5
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2617
Mailing Address - Country:US
Mailing Address - Phone:302-513-2881
Mailing Address - Fax:
Practice Address - Street 1:3304 DRUMMOND PLZ BLDG 3
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5710
Practice Address - Country:US
Practice Address - Phone:833-886-2277
Practice Address - Fax:302-454-1078
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL2-0024183164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse