Provider Demographics
NPI:1225415920
Name:TESEI, JOYANNE (PA)
Entity Type:Individual
Prefix:
First Name:JOYANNE
Middle Name:
Last Name:TESEI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:307 BOATNER RD
Mailing Address - Street 2:96 MDG FAMILY HEALTH CLINIC
Mailing Address - City:EGLIN AFB
Mailing Address - State:FL
Mailing Address - Zip Code:32542-1302
Mailing Address - Country:US
Mailing Address - Phone:850-883-8600
Mailing Address - Fax:
Practice Address - Street 1:7300 N PERIMETER RD
Practice Address - Street 2:
Practice Address - City:MALMSTROM AFB
Practice Address - State:MT
Practice Address - Zip Code:59402-6701
Practice Address - Country:US
Practice Address - Phone:064-731-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2022-10-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant