Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 6646 | CT |
N | 363LA2100X | Nurse Practitioner - Acute Care | F430842-1 | NY |
NPI | 1013326867 |
---|---|
Provider Name | Mrs. Jennifer Lynn Teichman |
First Address | Stamford, CT 06904-9317 |
Second Address | Stamford, CT 06904-9317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2014 |
Last Update Date | 10/09/2018 |