Angela Tennant, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3003096 Issued in KY

Practice address

1 Medical Village Drive
Edgewood, KY 41017

Phone

(859) 301-2000

Fax

(859) 426-4140

NPI assigned

Jan 11, 2008

Last updated

Aug 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Angela Havens Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1922284660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-2000",
            "fax_number": "859-426-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DRIVE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-2000",
            "fax_number": "859-426-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "ANGELA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3003096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78003951",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0163925",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201359370",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "HAVENS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kiara F Tasayco, OT
• Jessica Taylor
• Kylee M Taylor, RBT
• Nadya Taylor, CRNA
• Alvena Gigi Tcheng, MD
• Nicole Testory, MED. BCBA
• Ava Thaman, RBT
• Logan Scott Thayer, MD
• The Cranley Surgical Assoc,Inc.
• Hannah Elizabeth Thelen, CNP

• Nurse Practitioner in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.