Individual
MRS. TESHA ANN WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3354 JEROME LN, CAHOKIA, IL 62206-2604
(618) 337-9400
(618) 337-9394
Mailing address
3354 JEROME LN, CAHOKIA, IL 62206-2604
(618) 337-9400
(618) 337-9394
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041445665
IL
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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