Provider Demographics
NPI:1245032242
Name:WEBSTER, TEEANA
Entity type:Individual
Prefix:
First Name:TEEANA
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-3657
Mailing Address - Country:US
Mailing Address - Phone:317-939-8014
Mailing Address - Fax:317-939-8014
Practice Address - Street 1:2721 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-3657
Practice Address - Country:US
Practice Address - Phone:317-939-8014
Practice Address - Fax:317-939-8014
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN018415376K00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty