Provider Demographics
NPI:1669000840
Name:WARFIELD, TEKEYLA
Entity Type:Individual
Prefix:
First Name:TEKEYLA
Middle Name:
Last Name:WARFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9435 LACEE LN
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-3791
Mailing Address - Country:US
Mailing Address - Phone:662-544-0006
Mailing Address - Fax:
Practice Address - Street 1:106 N VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:WEINER
Practice Address - State:AR
Practice Address - Zip Code:72479-9289
Practice Address - Country:US
Practice Address - Phone:870-605-0014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000027001363LP2300X
AR124440363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care