Provider Demographics
NPI:1306236807
Name:TEETIE, GENEVIEVE RIVERA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:RIVERA
Last Name:TEETIE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 SWEDE RD
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1337
Mailing Address - Country:US
Mailing Address - Phone:610-742-8324
Mailing Address - Fax:
Practice Address - Street 1:599 ARCOLA RD
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3954
Practice Address - Country:US
Practice Address - Phone:484-565-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014718363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily