Provider Demographics
NPI:1003806951
Name:TETREAULT, COLETTE M (CNM)
Entity Type:Individual
Prefix:MS
First Name:COLETTE
Middle Name:M
Last Name:TETREAULT
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Gender:F
Credentials:CNM
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Mailing Address - Street 1:1700 HOSPITAL SOUTH DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-6810
Mailing Address - Country:US
Mailing Address - Phone:770-941-7717
Mailing Address - Fax:770-948-9729
Practice Address - Street 1:1700 HOSPITAL SOUTH DR
Practice Address - Street 2:SUITE 500
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-6810
Practice Address - Country:US
Practice Address - Phone:770-941-7717
Practice Address - Fax:770-948-9729
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GARN150205367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife