Provider Demographics
NPI:1386717429
Name:TEETOR, RAYNEE CELESTE (NP-C)
Entity type:Individual
Prefix:MS
First Name:RAYNEE
Middle Name:CELESTE
Last Name:TEETOR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 HEGNER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3615
Mailing Address - Country:US
Mailing Address - Phone:513-680-6582
Mailing Address - Fax:
Practice Address - Street 1:10550 MONTGOMERY RD STE 23
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4422
Practice Address - Country:US
Practice Address - Phone:513-680-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN315186163WG0000X
OHAPRN.CNP.0027555363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice