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General NPI Number Information
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NPI Number | 1841178134
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Entity Type | Individual
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Provider Name | BREANNA TEDFORD
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 7769 W STATE ROUTE 66
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City | NEWBURGH
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State | IN
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Zip | 47630-2544
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Country | US
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Telephone | 812-853-5339
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 JAMESTOWN CT
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City | EVANSVILLE
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State | IN
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Zip | 47715-3451
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26031433A
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License Number State | IN
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