Provider Demographics
NPI:1528155124
Name:KESTLER, TERESA FARRELL (FNP)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:FARRELL
Last Name:KESTLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 W VALENCIA RD
Mailing Address - Street 2:STE 110
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-6003
Mailing Address - Country:US
Mailing Address - Phone:520-751-3335
Mailing Address - Fax:520-547-5786
Practice Address - Street 1:1400 W VALENCIA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-6003
Practice Address - Country:US
Practice Address - Phone:520-751-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN120196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ73092Medicare UPIN