Provider Demographics
NPI:1780238048
Name:TEYTEL, RASA ABITAL (NP)
Entity type:Individual
Prefix:
First Name:RASA
Middle Name:ABITAL
Last Name:TEYTEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3941 HOLCOMB BRIDGE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2292
Mailing Address - Country:US
Mailing Address - Phone:404-429-4195
Mailing Address - Fax:678-221-3339
Practice Address - Street 1:3941 HOLCOMB BRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2292
Practice Address - Country:US
Practice Address - Phone:678-221-3333
Practice Address - Fax:678-221-3339
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN236121363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty