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General NPI Number Information
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NPI Number | 1568775724
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Entity Type | Individual
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Provider Name | TARRA DAWN TEETERS ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 1000 W MORENO ST
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City | PENSACOLA
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State | FL
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Zip | 32501-2316
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Country | US
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Telephone | 850-434-4694
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Fax | 850-469-7546
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Provider Business Mailing Address
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Address Line | 2005 MARQUESAS LN
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City | PENSACOLA
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State | FL
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Zip | 32506-7820
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Country | US
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Telephone | 850-723-8119
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9174737
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License Number State | FL
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