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NPI Code Detail

MEDICARE: BREANNA TEDFORD

MEDICARE: BREANNA TEDFORD
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
1183500000XPharmacist26031433AIN

General Provider Information

NPI Number : 1841178134
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA TEDFORD
Provider Business Mailing Address
First Line : 6101 JAMESTOWN CT
Second Line :
City : EVANSVILLE
State : IN
Zip : 47715-3451
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7769 W STATE ROUTE 66
Second Line :
City : NEWBURGH
State : IN
Zip : 47630-2544
Country : US
Telephone Number : 812-853-5339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2025
Last Update Date : 08/25/2025

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Directions to “ BREANNA TEDFORD ” Practice Location

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