Individual
MS. KACIE MILLER TEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
310 DAVIE AVE, STATESVILLE FAMILY PRACTICE, STATESVILLE, NC 28677-5319
(704) 873-3269
(704) 871-8159
Mailing address
PO BOX 896199 STATESVILLE FAMILY PRACTICE, CHARLOTTE, NC 28289-5319
(833) 936-1364
(605) 942-7505
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001000789
NC
Other
Enumeration date
01/24/2007
Last updated
03/09/2021
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