Provider Demographics
NPI:1407691470
Name:TENGRA, NANCY ROHINTON (NP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ROHINTON
Last Name:TENGRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PACIFIC BAY CIR APT 306
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-6151
Mailing Address - Country:US
Mailing Address - Phone:301-452-5638
Mailing Address - Fax:
Practice Address - Street 1:12 PACIFIC BAY CIR APT 306
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-6151
Practice Address - Country:US
Practice Address - Phone:301-452-5638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030066363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care