Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R205596 | MD |
N | 363LP2300X | Nurse Practitioner - Primary Care | SP016378 | PA |
NPI | 1073956157 |
---|---|
Provider Name | Mrs. Melissa Ann Teets |
First Address | Scottsdale, AZ 85258-5199 |
Second Address | Scottsdale, AZ 85258-5172 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 21/07/2020 |