Laurie B Teal, PMHNP
Nurse Practitioner, Psych/Mental Health in Shushan, NY. Individual provider (NPI-1).
NPI number1114447166
StatusActive
Last updated in NPPESMar 10, 2022
Details
- NPI
- 1114447166
- Entity type
- Individual (NPI-1)
- Name
- Laurie B Teal
- Credential
- PMHNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 21, 2017
- Certification date
- Mar 10, 2022
- Last updated
- Mar 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 101-0131597 | VT | Yes |
Practice location
725 Juniper Swamp RdShushan, NY 12873-2910
Phone 518-812-6842 · Fax 518-338-0174
Mailing address
725 Juniper Swamp RdShushan, NY 12873-2910
Phone 518-812-6842 · Fax 518-338-0174
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