Basic Information
| Provider Information | |||||||||
| NPI: | 1316911647 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUETING | ||||||||
| FirstName: | TERESA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1833 | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950611833 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4663 SCOTTS VALLEY DR | ||||||||
| Address2: | |||||||||
| City: | SCOTTS VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950664202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314586335 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | NP11553 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.