Provider Demographics
NPI:1598157224
Name:TEFFETELLER, SUSAN PRICE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:PRICE
Last Name:TEFFETELLER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 FRANK L DIGGS ROAD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716
Mailing Address - Country:US
Mailing Address - Phone:865-647-3300
Mailing Address - Fax:865-647-3309
Practice Address - Street 1:159 FRANK L DIGGS ROAD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716
Practice Address - Country:US
Practice Address - Phone:865-647-3300
Practice Address - Fax:865-647-3309
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily