Provider Demographics
NPI:1881677045
Name:GAETA, TERESA RUDD (MSN,CNP)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:RUDD
Last Name:GAETA
Suffix:
Gender:F
Credentials:MSN,CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38646 BELL RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7522
Mailing Address - Country:US
Mailing Address - Phone:440-269-1527
Mailing Address - Fax:
Practice Address - Street 1:29400 LAKELAND BLVD
Practice Address - Street 2:LUBRIZOL CORPORATION MEDICAL DEPAR
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092
Practice Address - Country:US
Practice Address - Phone:440-347-2411
Practice Address - Fax:440-347-4704
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN155522 NP01623363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health