Provider Demographics
NPI:1487964508
Name:TEAPE, ELETH P (RN)
Entity type:Individual
Prefix:MRS
First Name:ELETH
Middle Name:P
Last Name:TEAPE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6334 DORSETT SHOALS RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-4624
Mailing Address - Country:US
Mailing Address - Phone:770-826-3959
Mailing Address - Fax:
Practice Address - Street 1:6334 DORSETT SHOALS RD
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-4624
Practice Address - Country:US
Practice Address - Phone:770-826-3959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-08
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN138662171M00000X, 251J00000X, 253Z00000X, 251F00000X, 164W00000X, 163W00000X, 174H00000X, 163WA2000X, 163WC0400X, 163WC1600X, 163WC1500X, 163WC2100X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No251F00000XAgenciesHome Infusion
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care