Provider Demographics
NPI:1326938028
Name:MONG, TESS DELANN (APRN)
Entity type:Individual
Prefix:
First Name:TESS
Middle Name:DELANN
Last Name:MONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:DELANN
Other - Last Name:CANTRALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4708 ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-8946
Mailing Address - Country:US
Mailing Address - Phone:941-773-8350
Mailing Address - Fax:
Practice Address - Street 1:8950 9TH ST N STE 102
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-3001
Practice Address - Country:US
Practice Address - Phone:727-498-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL110403388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily