Individual
KATHLEEN D TETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5887 GLENRIDGE DR NE, SUITE 140, ATLANTA, GA 30328-5574
(678) 705-7341
(678) 973-0578
Mailing address
5887 GLENRIDGE DR NE, SUITE 140, ATLANTA, GA 30328-5574
(678) 705-7341
(678) 973-0578
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R090588
GA
Other
Enumeration date
12/06/2006
Last updated
02/20/2012
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