Provider Demographics
NPI:1538821657
Name:GREUNKE, TENISHA (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TENISHA
Middle Name:
Last Name:GREUNKE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-5768
Mailing Address - Country:US
Mailing Address - Phone:208-930-1000
Mailing Address - Fax:877-376-4040
Practice Address - Street 1:2139 N MAIN ST
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5768
Practice Address - Country:US
Practice Address - Phone:208-930-1000
Practice Address - Fax:877-376-4040
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID9871486363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner