Provider Demographics
NPI:1215049895
Name:SAUNDERS, TEDDA JEAN (RN, CNS)
Entity type:Individual
Prefix:MS
First Name:TEDDA
Middle Name:JEAN
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-7413
Mailing Address - Country:US
Mailing Address - Phone:804-221-6728
Mailing Address - Fax:
Practice Address - Street 1:204 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-7413
Practice Address - Country:US
Practice Address - Phone:804-221-6728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001041476163W00000X
VA0015000406364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse