Individual
MS. MALINDA TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2406 BLUE RIDGE RD STE 100, RALEIGH, NC 27607
(919) 786-5001
(919) 786-5051
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010373
NC
363LP0200X
Pediatric Nurse Practitioner
209-004496
IL
363LP0200X
Pediatric Nurse Practitioner
250343
MA
363LP0200X
Pediatric Nurse Practitioner
286171
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568654903
—
NC
Enumeration date
08/09/2007
Last updated
03/16/2021
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