Provider Demographics
NPI:1134670052
Name:TEACHOUT, CHRISTY BRADLEY (NP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:BRADLEY
Last Name:TEACHOUT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25535 CALDERA DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-8346
Mailing Address - Country:US
Mailing Address - Phone:520-360-2143
Mailing Address - Fax:256-880-0395
Practice Address - Street 1:333 WHITESPORT DR SW
Practice Address - Street 2:SUITE 104
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6454
Practice Address - Country:US
Practice Address - Phone:256-880-0376
Practice Address - Fax:256-880-0395
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-137029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily