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1679024798
TERESA ANNE DISTLER
FORT LEONARD WOOD, MO
NPI
1679024798
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 2016037029)
Enumeration Date
2016-10-24
Last Update Date
2022-08-10
Business Address
TERESA ANNE DISTLER NP-C
4430 MISSOURI AVE
FORT LEONARD WOOD, MO 65473-9098
Phone number: 573-596-1765
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Mailing Address
TERESA ANNE DISTLER NP-C
12103 COUNTY LINE RD
RUSSELLVILLE, MO 65074-2814
Phone number: 573-690-6271
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