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NPI Code Detail

MEDICARE: ERICA JANELLE TEAGUE

MEDICARE: ERICA JANELLE TEAGUE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN.CNP.0039831OH

General Provider Information

NPI Number : 1104627413
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA JANELLE TEAGUE
Provider Business Mailing Address
First Line : 2532 CRANFORD RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43221-1106
Country : US
Telephone Number : 765-376-5973
Fax Number :
Provider Business Practice Location Address
First Line : 7400 HUNTINGTON PARK DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-5617
Country : US
Telephone Number : 765-376-5973
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2025
Last Update Date : 01/21/2026

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Directions to “ ERICA JANELLE TEAGUE ” Practice Location

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