Provider Demographics
NPI:1851433908
Name:ROYSE, TEATHER LYNNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TEATHER
Middle Name:LYNNE
Last Name:ROYSE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:STE. 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:6081 HAMILTON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106-9801
Practice Address - Country:US
Practice Address - Phone:610-841-4404
Practice Address - Fax:484-403-4026
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA002715L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical