Individual
MR. BARRETT M TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
3920 S DUPONT SQ, LOUISVILLE, KY 40207-4615
(812) 282-3899
(812) 282-4172
Mailing address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
(812) 282-3899
(812) 282-4172
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3008113
KY
363L00000X
Nurse Practitioner
71008934A
IN
363LF0000X
Family Nurse Practitioner
3008113
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100579260
—
KY
01
—
K270612
KY MEDICARE
KY
Enumeration date
07/18/2013
Last updated
04/23/2019
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