Provider Demographics
NPI:1811018773
Name:TEAL, DONNA ROSE (APN, RNC, CRNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ROSE
Last Name:TEAL
Suffix:
Gender:F
Credentials:APN, RNC, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STACY CIR
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MTN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-1943
Mailing Address - Country:US
Mailing Address - Phone:423-886-6137
Mailing Address - Fax:
Practice Address - Street 1:207 SPEARS AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3840
Practice Address - Country:US
Practice Address - Phone:423-756-7644
Practice Address - Fax:423-756-7646
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000085318363LA2200X
TNAPN#0000006466363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily