Provider Demographics
NPI:1598282634
Name:NEE, TEDDI ROSE (DNP)
Entity Type:Individual
Prefix:DR
First Name:TEDDI
Middle Name:ROSE
Last Name:NEE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 701
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-0701
Mailing Address - Country:US
Mailing Address - Phone:541-371-2511
Mailing Address - Fax:
Practice Address - Street 1:5 W ALDER ST STE 342
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2849
Practice Address - Country:US
Practice Address - Phone:541-371-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60790063363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health