Individual
MICHELLE TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2275 INDIA HOOK RD, ROCK HILL, SC 29732-1223
(803) 329-1500
Mailing address
104 CHESTNUT ST, GREENVILLE, SC 29605-4301
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
23596
SC
363LF0000X
Family Nurse Practitioner
Primary
23596
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6826
—
SC
Enumeration date
02/06/2020
Last updated
02/24/2025
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