MEDICARE: CHERISE 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP034739	PA

General Provider Information

NPI Number	:	1609730944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERISE TEAGUE

Provider Business Mailing Address
First Line	:	2395 LANCASTER PIKE FL 1
Second Line	:
City	:	READING
State	:	PA
Zip	:	19607-2375
Country	:	US
Telephone Number	:	570-561-2990
Fax Number	:	833-411-5741

Provider Business Practice Location Address
First Line	:	2395 LANCASTER PIKE FL 1
Second Line	:
City	:	READING
State	:	PA
Zip	:	19607-2375
Country	:	US
Telephone Number	:	570-561-2990
Fax Number	:	833-411-5741

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ CHERISE TEAGUE ” Practice Location

Language	Start Address	Practice Location

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