Provider Demographics
NPI:1871208678
Name:TENBUSCH, MARITZA (FNP-C)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:TENBUSCH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MARITZA
Other - Middle Name:
Other - Last Name:TENBUSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:23287 WOODHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3124
Mailing Address - Country:US
Mailing Address - Phone:734-340-7688
Mailing Address - Fax:
Practice Address - Street 1:23287 WOODHAVEN CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335
Practice Address - Country:US
Practice Address - Phone:734-340-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704343844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty