Individual
MRS. HEATHER TEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, AGPCNP
Contact information
Practice address
351 W CAMDEN ST, BALTIMORE, MD 21201-7912
(414) 852-5954
Mailing address
351 W CAMDEN ST, BALTIMORE, MD 21201-7912
(414) 852-5954
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
135580
WI
363LA2200X
Adult Health Nurse Practitioner
Primary
6263
WI
Other
Enumeration date
04/15/2015
Last updated
04/23/2015
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