Provider Demographics
NPI:1124160361
Name:TEDDER, JANICE LEE (RN,FNP)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LEE
Last Name:TEDDER
Suffix:
Gender:F
Credentials:RN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:590 MANNING DR
Mailing Address - Street 2:CB 7586
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-2414
Mailing Address - Country:US
Mailing Address - Phone:919-843-3003
Mailing Address - Fax:919-966-6125
Practice Address - Street 1:590 MANNING DR
Practice Address - Street 2:CB 7586
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7586
Practice Address - Country:US
Practice Address - Phone:919-843-3003
Practice Address - Fax:919-966-6125
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC051328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily