Provider Demographics
NPI:1538821657
Name:GREUNKE, TENISHA (RN)
Entity type:Individual
Prefix:MRS
First Name:TENISHA
Middle Name:
Last Name:GREUNKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1452 OAK TREE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-9013
Mailing Address - Country:US
Mailing Address - Phone:903-780-6981
Mailing Address - Fax:855-949-3731
Practice Address - Street 1:1452 OAK TREE DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-9013
Practice Address - Country:US
Practice Address - Phone:979-627-3011
Practice Address - Fax:855-949-3731
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234036164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse