Nicole Virginia Tennison
Individual provider Active NPI Home Health Agency · Lothian, MD
NPI 1215505367 · NPPES record last updated Jun 15, 2021
Key facts
- NPI
- 1215505367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Agency 251E00000X
- License
- A00087423 (MD)
- Practice address
- 1140 Marlboro Rd
Lothian, MD 20711-9539 - Phone
- (410) 271-5543
- NPI assigned
- Jun 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A00087423 | MD | MD | Home Health Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | A00087423 | MD | Yes |
Addresses
Primary practice location
1140 Marlboro Rd
Lothian, MD 20711-9539
Mailing address
1140 Marlboro Rd
Lothian, MD 20711-9539
Phone (410) 271-5543
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A00087423 | Other | MD | BON |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | ntennison22@gmail.com |
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- Catherine Lee McDermott
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- Maria Joy Prout
- Sophworks Recovery Group, LLC
- Emma Woznysmith
- Eric Dasie Woznysmith
- Mary M Woznysmith
All providers in Lothian, MD · Home Health Agency in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.