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General NPI Number Information
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NPI Number | 1952817397
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Entity Type | Individual
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Provider Name | TERESA MARIE SUTTON NP
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Gender | Female
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1399 N BALDWIN AVE
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City | MARION
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State | IN
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Zip | 46952-1913
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Country | US
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Telephone | 765-660-7550
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Fax | 765-662-4467
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Provider Business Mailing Address
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Address Line | 1399 N BALDWIN AVE
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City | MARION
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State | IN
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Zip | 46952-1913
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Country | US
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Telephone | 765-660-7550
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Fax | 656-624-4677
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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 | 28145560A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 71007683A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71007683A
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License Number State | IN
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