Individual
MRS. TERESA JO ETHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8229 SHOAL CREEK BLVD STE 105, AUSTIN, TX 78757-7556
(737) 245-7587
Mailing address
8229 SHOAL CREEK BLVD STE 105, AUSTIN, TX 78757-7556
(817) 939-1322
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1019215
TX
Other
Enumeration date
11/09/2020
Last updated
02/15/2023
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