Healthcare Provider Details

I. General information

NPI: 1932654555
Provider Name (Legal Business Name): TEAL MEFFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 WASHINGTON ST
THORNTON CO
80229-2050
US

IV. Provider business mailing address

10001 WASHINGTON ST
THORNTON CO
80229-2050
US

V. Phone/Fax

Practice location:
  • Phone: 303-252-4442
  • Fax:
Mailing address:
  • Phone: 303-252-4442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0992506-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: