Individual
SONJA SUE TEDLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2233 W JEFFERSON ST, KOKOMO, IN 46901-4185
(765) 457-9175
Mailing address
2233 W JEFFERSON ST, KOKOMO, IN 46901-4185
(765) 457-9175
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
28141196A
IN
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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