Provider Demographics
NPI:1801058722
Name:TEELIN, JOY L (NP)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:L
Last Name:TEELIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:L
Other - Last Name:GASPARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-1830
Practice Address - Country:US
Practice Address - Phone:608-263-1530
Practice Address - Fax:608-265-8887
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI141847-030363L00000X
WI3560-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1801058722Medicaid
WI60819OtherDEAN HEALTH INSURANCE
WI36091700Medicaid