Individual
NICOLE TEIGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3099 NE DIAMOND LAKE BLVD, ROSEBURG, OR 97470-3655
(541) 673-3469
(541) 440-3554
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 440-3532
(541) 440-3554
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
164W00000X
Licensed Practical Nurse
Primary
202111476LPN
OR
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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