Provider Demographics
NPI:1811452204
Name:TETTEH, JANET MARIE (FNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:TETTEH
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 1:4000 E RENNER RD APT 2033
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2722
Mailing Address - Country:US
Mailing Address - Phone:214-790-6778
Mailing Address - Fax:
Practice Address - Street 1:854 BAUGH DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5565
Practice Address - Country:US
Practice Address - Phone:214-228-9319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-10
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily