Vandelia Teal-surratt NP

NPI 1083980700 - Nurse Practitioner - 363LA2200X

NPI Details
NPI 1083980700
Gender Female
Enumeration Date 03/27/2012
Last Updated 05/22/2015
Entity Type Individual
Active Over 4 years ago
Practice Location
5665 NEW NORTHSIDE DR STE 320
ATLANTA GA, 30328-5834, US
Phone (404) 645-7563
Fax (770) 874-6884
Business Location
1469 HILLIAN EDWARDS RD
CHERAW SC, 29520-5652, US
Phone (843) 910-7587
Fax
Toxanomy
Taxonomy Code 363LA2200X
License State South Carolina
License Number 17777
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According to our database, Vandelia Teal-surratt NP NPI is 1083980700, taxonomy code is 363LA2200X and license number is 17777, license state is located at South Carolina. Vandelia Teal-surratt NP physically located at 5665 New Northside Dr Ste 320, Atlanta GA, 30328-5834. NPI Number Vandelia Teal-surratt NP has the Individual type.

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1083980700 NPI number is provided on an as is basis without warranty of any kind. 1083980700 is maintained by the National Plan & Provider Enumeration System. The contents of Vandelia Teal-surratt NP are for informational purposes only.