| NPI | 1114256138 |
|---|---|
| Former Name | FAWN LYNN TETER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP028282) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN581431) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP016692) | |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2025-10-02 |