Individual
MS. JOIE LYNN TEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,FNP-C
Contact information
Practice address
1225 HANCOCK RD, BLDG C, STE 302, BULLHEAD CITY, AZ 86442
(928) 440-6995
(928) 404-9175
Mailing address
1225 HANCOCK RD, BLDG C, STE 302, BULLHEAD CITY, AZ 86442-8624
(928) 440-6995
(928) 404-9175
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
235928
AZ
363LP2300X
Primary Care Nurse Practitioner
235928
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003840
—
AZ
05
—
201108380A
—
KS
01
—
MT3334303
DEA
KS
Enumeration date
04/20/2014
Last updated
10/07/2024
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