Provider Demographics
NPI:1205473782
Name:TENNEY, MADALYNN (CRPNP AC/PC)
Entity type:Individual
Prefix:
First Name:MADALYNN
Middle Name:
Last Name:TENNEY
Suffix:
Gender:F
Credentials:CRPNP AC/PC
Other - Prefix:
Other - First Name:MADALYNN
Other - Middle Name:
Other - Last Name:TENNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7401 GREENBELT RD
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3402
Mailing Address - Country:US
Mailing Address - Phone:301-982-5437
Mailing Address - Fax:
Practice Address - Street 1:7401 GREENBELT RD
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3402
Practice Address - Country:US
Practice Address - Phone:240-494-6066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178527363LP0200X
MDR192771363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics