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NPI Code Detail

MEDICARE: STEPHANIE LARAE TEAGUE

MEDICARE: STEPHANIE LARAE 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
1146L00000XParamedic56005NV

General Provider Information

NPI Number : 1588139620
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE LARAE TEAGUE
Provider Business Mailing Address
First Line : 9 W DELHI AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7836
Country : US
Telephone Number : 702-650-9900
Fax Number :
Provider Business Practice Location Address
First Line : 9 W DELHI AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7836
Country : US
Telephone Number : 702-650-9900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2018
Last Update Date : 10/04/2018

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Directions to “ STEPHANIE LARAE TEAGUE ” Practice Location

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