Individual
STACEY LYNN TEAGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 E 8TH ST, JAMESTOWN, NY 14701-3502
(716) 483-4203
Mailing address
50 E 8TH ST, JAMESTOWN, NY 14701-3502
(716) 483-4203
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
512779-1
NY
Other
Enumeration date
09/30/2021
Last updated
09/30/2021
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