Provider Demographics
NPI:1063161628
Name:TEETER, KATHERINE E (NP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:TEETER
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S BOYLAN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1802
Mailing Address - Country:US
Mailing Address - Phone:919-833-7526
Mailing Address - Fax:919-390-1384
Practice Address - Street 1:105 NEWSOM ST STE 101
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2197
Practice Address - Country:US
Practice Address - Phone:919-286-2872
Practice Address - Fax:919-433-0360
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021017363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health