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NPI Code Detail

MEDICARE: EMILY TEAGUE

MEDICARE: EMILY TEAGUE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist157119OH

General Provider Information

NPI Number : 1487519617
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY TEAGUE
Provider Business Mailing Address
First Line : 55 BETHEL RD
Second Line :
City : DAYTON
State : OH
Zip : 45458-2464
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3535 SOUTHERN BLVD
Second Line :
City : KETTERING
State : OH
Zip : 45429-1221
Country : US
Telephone Number : 937-298-4331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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Directions to “ EMILY TEAGUE ” Practice Location

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