Provider Demographics
NPI:1942089503
Name:SUTTON, TERESA CHRISTI (LPN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:CHRISTI
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3207 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-6211
Mailing Address - Country:US
Mailing Address - Phone:309-235-3861
Mailing Address - Fax:
Practice Address - Street 1:3207 24TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-6211
Practice Address - Country:US
Practice Address - Phone:309-235-3861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043.117063164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse