Individual
ACACIA NICHOLE TEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
Mailing address
1524 SEDGEWICK CT, ELKHART, IN 46516-5696
(574) 370-1378
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27075127A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1038822886
—
IN
Enumeration date
03/25/2019
Last updated
05/05/2023
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