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General NPI Number Information
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NPI Number | 1568835890
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Entity Type | Individual
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Provider Name | TERESA MARIE GAITHER FNP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 16515 S. 40TH ST, BLDG 9, SUITE 143
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City | PHOENIX
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State | AZ
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Zip | 85048-0560
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Country | US
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Telephone | 480-712-8319
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Fax | 480-712-1305
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Provider Business Mailing Address
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Address Line | 3083 S COTTONWOOD CT
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City | CHANDLER
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State | AZ
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Zip | 85286-2384
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Country | US
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Telephone | 480-712-8319
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Fax | 480-712-1305
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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 | AP8166
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License Number State | AZ
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