Provider Demographics
NPI:1487811220
Name:TEHN-ADDY, ANNETTE NANA (RN)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:NANA
Last Name:TEHN-ADDY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ANNETTE
Other - Middle Name:NANA
Other - Last Name:BOAHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:221 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-1921
Mailing Address - Country:US
Mailing Address - Phone:631-940-0454
Mailing Address - Fax:631-242-3186
Practice Address - Street 1:221 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-1921
Practice Address - Country:US
Practice Address - Phone:631-940-0454
Practice Address - Fax:631-242-3186
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY559518163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse