| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DIANE R TEAL | 1871911818 | 2024-09-06 |
Diane Renae Teal [F] graduated in 2013 and primarily specializes in Nurse Practitioner.
Diane R Teal is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1871911818. Registration indicates Diane R Teal is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers)
| PECOS ID | 7810208840 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Diane R Teal CRNP |
| Practice Office Address | 1026 GOODYEAR AVE STE 200 GADSDEN, AL US |
| Practice Office Telephone | 2565433977 |
| Practice Office Fax | 2564136330 |
| Mailing Address | 200 OFFICE PARK DR GULF SHORES, AL 365423432 US |
| Business Telephone | 2519687379 |
| Business Fax | 2519685960 |
| AMR Direct Address [] | [email protected] | |
| Direct Messaging Address [] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 363L00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner All Other Specialties & Provider Types Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers | 1-128203
AL |
| 250274 | MEDICAID | AL |