Tequila J Staten ARNP

NPI 1043549918 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1043549918
Gender Female
Enumeration Date 12/23/2009
Last Updated 07/21/2014
Entity Type Individual
Active Over 6 years ago
Practice Location
1330 N RACE ST
GLASGOW KY, 42141-3465, US
Phone (270) 629-5111
Fax (270) 629-5115
Business Location
201 PARK ST
BOWLING GREEN KY, 42101-1759, US
Phone (270) 780-2497
Fax (270) 783-3750
Toxanomy
Taxonomy Code 363LF0000X
License State Kentucky
License Number 3006238
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According to our database, Ms. Tequila J Staten ARNP NPI is 1043549918, taxonomy code is 363LF0000X and license number is 3006238, license state is located at Kentucky. Tequila J Staten ARNP physically located at 1330 N Race St, Glasgow KY, 42141-3465. NPI Number Tequila J Staten ARNP has the Individual type.

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1043549918 NPI number is provided on an as is basis without warranty of any kind. 1043549918 is maintained by the National Plan & Provider Enumeration System. The contents of Tequila J Staten ARNP are for informational purposes only.