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General NPI Number Information
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NPI Number | 1407653744
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Entity Type | Individual
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Provider Name | ERNEST ALLEN TEEGARDEN JR. CNP
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Gender | Male
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 705 17TH ST N
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City | VIRGINIA
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State | MN
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Zip | 55792-2176
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Country | US
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Telephone | 877-651-4637
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Fax | 877-651-1381
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Provider Business Mailing Address
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Address Line | PO BOX 135
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City | BIGFORK
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State | MN
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Zip | 56628-0135
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Country | US
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Telephone | 218-743-3232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12213
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License Number State | MN
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