Provider Demographics
NPI:1609570969
Name:TEEL, TERESA TESHEA (APRN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:TESHEA
Last Name:TEEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 GULF BREEZE PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3091
Mailing Address - Country:US
Mailing Address - Phone:850-934-5713
Mailing Address - Fax:850-934-0379
Practice Address - Street 1:2744 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3091
Practice Address - Country:US
Practice Address - Phone:850-934-5713
Practice Address - Fax:850-934-0379
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11025537363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty