Provider Demographics
NPI:1912557166
Name:STUDER, TEARA K
Entity Type:Individual
Prefix:
First Name:TEARA
Middle Name:K
Last Name:STUDER
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 1:555 FLYING V ST STE 5
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-7698
Mailing Address - Country:US
Mailing Address - Phone:530-638-5776
Mailing Address - Fax:
Practice Address - Street 1:3355 HORSE CAMP RD
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:CA
Practice Address - Zip Code:96022-9246
Practice Address - Country:US
Practice Address - Phone:530-638-5776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA697467164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse