Provider Demographics
NPI:1205455565
Name:TEASE, ANASTASIA G
Entity type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:G
Last Name:TEASE
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 1:1101 ERIN LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2289
Mailing Address - Country:US
Mailing Address - Phone:256-497-8290
Mailing Address - Fax:
Practice Address - Street 1:1101 ERIN LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2289
Practice Address - Country:US
Practice Address - Phone:256-497-8290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program