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General NPI Number Information
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NPI Number | 1912234824
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Entity Type | Individual
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Provider Name | LYNETTE ANN TEEGERSTROM RPH
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Gender | Female
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Dates
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Enumeration Date | 11/13/2009
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Last Update Date | 11/13/2009
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Provider Practice Location Address
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Address Line | 6900 GEORGIA AVE NW BLDG 2 ROOM 6P02
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City | WASHINGTON
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State | DC
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Zip | 20307-0003
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Country | US
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Telephone | 202-782-3727
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Fax |
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Provider Business Mailing Address
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Address Line | 5210 3RD ST NE APT 302
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City | WASHINGTON
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State | DC
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Zip | 20011-6337
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Country | US
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Telephone | 402-239-4132
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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 | 10738
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License Number State | NE
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