Provider Demographics
NPI:1487409082
Name:BROWN, TENEISHA DANIELLE (CPT, CPI,)
Entity type:Individual
Prefix:
First Name:TENEISHA
Middle Name:DANIELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CPT, CPI,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 COLLEY AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2679
Mailing Address - Country:US
Mailing Address - Phone:703-609-6711
Mailing Address - Fax:
Practice Address - Street 1:3611 COLLEY AVE APT 101
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2679
Practice Address - Country:US
Practice Address - Phone:703-609-6711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1063871246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy