Provider Demographics
NPI:1396079240
Name:PAGE, TERI (LPN)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8672 HIGH ROCK RD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45135-9702
Mailing Address - Country:US
Mailing Address - Phone:937-205-9525
Mailing Address - Fax:
Practice Address - Street 1:8672 HIGH ROCK RD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:OH
Practice Address - Zip Code:45135-9702
Practice Address - Country:US
Practice Address - Phone:937-205-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant