MR. TRISTAN MCKENNA (NPI# 1912354739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912354739 |
| Entity Type | Individual |
| Full Name | MR. TRISTAN MCKENNA |
| Credential | FNP-C |
| Practice Address |
1415 Physicians Dr Wilmington NC 28401-7338 |
| Mailing Address |
Po Box 602484 Charlotte NC 28260-2484 |
| Practice Telephone | 9106629500 |
| Practice Fax Number | 9106629501 |
| Mailing Telephone | 9106629500 |
| Mailing Fax Number | 9106629501 |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
260336 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1912354739 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417304403 | Tristan Joseph Mckenna | Student in an Organized Health Care Education/Training Program | 3269 N Stockton Hill Rd, Kingman, AZ 86409 | 2016-05-19 |
| Street Address |
1415 PHYSICIANS DR |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-7338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679577407 | Robert Alan Ashworth | Pharmacist | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2005-06-09 |
| 1972158434 | Mary Hamrick | Nurse Practitioner | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2019-08-01 |
| 1750892865 | Danielle Wright | Pharmacist | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2017-10-16 |
| 1881120806 | Christina Lafoon | Nurse Practitioner | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2017-05-11 |
| 1982006110 | David Ryan | Nurse Practitioner | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2014-09-18 |
| 1922431576 | Edith Mintz | Physician Assistant | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2013-08-19 |
| 1740523976 | George Mcleod | Internal Medicine | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2013-04-06 |
| 1275889602 | Rachel March | Social Worker | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2012-08-03 |
| 1134400799 | Monica Hill | Nurse Practitioner | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2011-09-08 |
| 1407140973 | Ellen Klaenhammer | Physician Assistant | 1415 Physicians Dr, Wilmington, NC 28401-7338 | 2011-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609488428 | Samantha Kuhlman | Nurse Practitioner | 1509 Doctors Cir Bldg C, Wilmington, NC 28401-7403 | 2020-08-21 |
| 1023630290 | Carole King Stevenson | Nurse Practitioner | 1111 Figueroa Pl # Tech115, Wilmington, CA 90744-2311 | 2020-05-11 |
| 1962031039 | Jasmine Marie Locklear | Nurse Practitioner | 2550 41st St, Wilmington, NC 28403-5519 | 2020-04-02 |
| 1811558422 | Emma Rose Boisvert I | Nurse Practitioner | Deerfield Valley Health Center, 30 Route 100 South, Wilmington, VT 05363-0536 | 2019-06-25 |
| 1922569482 | Joy Peterson | Nurse Practitioner | 1815 W 13th St Ste 1, Wilmington, DE 19806-4054 | 2019-03-27 |
| 1104382308 | Caitlin Gallagher | Nurse Practitioner | 608 Dawson St Ste 103, Wilmington, NC 28401-5712 | 2019-02-13 |
| 1407344476 | Adelle Grant-mcauley | Nurse Practitioner | 3521 Silverside Rd., Quillen Building Suite 2j, Wilmington, DE 19810 | 2018-04-25 |
| 1538674767 | Angela M Mcnulty | Nurse Practitioner | 3521 Silverside Rd Ste 1c, Wilmington, DE 19810-4900 | 2017-12-11 |
| 1851804694 | Laura Jean Cornelis | Nurse Practitioner | 908b East 16th Street, Wilmington, DE 19802 | 2017-11-15 |
| 1952825168 | Alicia Camille Vogleson | Nurse Practitioner | 2601 Annand Dr Ste 3, Wilmington, DE 19808-3719 | 2017-07-29 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
Please comment or provide details below to improve the information on MR. TRISTAN MCKENNA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.