Provider Demographics
NPI:1740874932
Name:TEASHIA DUNN, P.C.
Entity type:Organization
Organization Name:TEASHIA DUNN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEASHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROESKE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:757-504-0247
Mailing Address - Street 1:1618 LECKIE ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-1718
Mailing Address - Country:US
Mailing Address - Phone:843-263-8497
Mailing Address - Fax:
Practice Address - Street 1:6330 NEWTOWN RD STE 250
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4802
Practice Address - Country:US
Practice Address - Phone:757-504-0247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-27
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty