Provider Demographics
NPI:1275096034
Name:SYKES, TEALE ANDREASON (PA-C)
Entity type:Individual
Prefix:
First Name:TEALE
Middle Name:ANDREASON
Last Name:SYKES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TEALE
Other - Middle Name:DENAE
Other - Last Name:ANDREASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 749495
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9495
Mailing Address - Country:US
Mailing Address - Phone:855-963-2100
Mailing Address - Fax:813-321-1296
Practice Address - Street 1:6985 MCGINNIS FERRY RD STE 100
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1547
Practice Address - Country:US
Practice Address - Phone:678-726-6203
Practice Address - Fax:678-647-7955
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9112010363A00000X
GA13099363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102840900Medicaid