Healthcare Provider Details

I. General information

NPI: 1063161628
Provider Name (Legal Business Name): KATHERINE E TEETER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 NEWSOM ST STE 101
DURHAM NC
27704-2197
US

IV. Provider business mailing address

100 S BOYLAN AVE
RALEIGH NC
27603-1802
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-2872
  • Fax: 919-433-0360
Mailing address:
  • Phone: 919-833-7526
  • Fax: 919-390-1384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5021017
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: