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General NPI Number Information
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NPI Number | 1518457357
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Entity Type | Individual
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Provider Name | VICKI TEAL FNP
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Gender | Female
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 655 W 8TH ST FL CENTER1
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-244-5044
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Fax | 904-244-4508
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Provider Business Mailing Address
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Address Line | 4205 BELFORT RD STE 4015
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City | JACKSONVILLE
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State | FL
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Zip | 32216-3623
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Country | US
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Telephone | 904-296-5691
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Fax | 904-450-6401
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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 | APRN9270069
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License Number State | FL
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