Basic Information
| Provider Information | |||||||||
| NPI: | 1124160361 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TEDDER | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN,FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 590 MANNING DR | ||||||||
| Address2: | CB 7586 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275992414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198433003 | ||||||||
| FaxNumber: | 9199666125 | ||||||||
| Practice Location | |||||||||
| Address1: | 590 MANNING DR | ||||||||
| Address2: | CB 7586 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997586 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198433003 | ||||||||
| FaxNumber: | 9199666125 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 07/19/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 051328 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.