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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NICHOLAS HENRY TANNENBAUM

Active Sole Proprietor

NICHOLAS HENRY TANNENBAUM is a Emergency Medical Services healthcare provider located in FORT BRAGG, North Carolina. NPI 1013584382 is currently active in the NPPES registry. Verify at CMS.

Emergency Medical Services · FORT BRAGG, NC

Registration Details

NPI Number
1013584382
Provider Type
Individual
Gender
Male
NPI Issued
Jun 7, 2021 (5.2104225661998 yrs)
Last Updated
Jan 30, 2026
Licenses
12918 (GA)
2024-01464 (NC)
Sole Proprietor
Yes

Practice Information

Address
2817 ROCK MERRITT AVE
FORT BRAGG, NC, 283100004
Browse NC providers · Browse ZIP 28310
Phone
9109078922
Fax
9109076069
Primary Specialty
Emergency Medical Services
207PE0004X
Additional Specialty
Emergency Medical Services
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.