Individual
KATHY FRANCES TEBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
420 E MAIN ST, BROOK, IN 47922-8715
(219) 275-2521
(219) 275-9342
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28190154A
IN
363LF0000X
Family Nurse Practitioner
Primary
71011915A
IN
Other
Enumeration date
11/10/2021
Last updated
02/23/2024
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