Laura Jean Kistler Tetterton, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

084764 Issued in NC

Practice address

508 Fulton St
Surgical Services (112)
Durham, NC 27705-3875

Phone

(919) 416-5867

NPI assigned

Jun 23, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Laura Jean Kistler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1285895201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3507",
            "address_2": "ERWIN ROAD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-684-4117",
            "fax_number": "919-681-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "address_2": "SURGICAL SERVICES (112)",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-416-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETTERTON",
        "first_name": "LAURA",
        "middle_name": "JEAN KISTLER",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "084764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "KISTLER",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Lee Terwilliger, CRNP
• Deanna Marie Tesch, MS, LMFTA
• Hanna Tesfaye, DO
• Amanda Coats Testino, MS-CCC, SLP
• Jayme Rebeccah Tetro, MSW, LCSW
• Christine D. Tew, LPC
• Karen Elizabeth Tew, MD
• Amanda Leigh Tewell, LPCA
• Dolphus Allen Thacker III, DC
• Julie Kay Marosky Thacker, M.D.

• Adult Health Nurse Practitioner in Durham, NC
• Providers in Durham, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.