Basic Information
| Provider Information | |||||||||
| NPI: | 1619019718 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEBER | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1115 BOULDERS PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | NORTH CHESTERFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232254067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8045605595 | ||||||||
| FaxNumber: | 8045609029 | ||||||||
| Practice Location | |||||||||
| Address1: | 8266 ATLEE RD | ||||||||
| Address2: | SUITE 133 | ||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231161804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047302121 | ||||||||
| FaxNumber: | 8047300563 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 01/31/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 0001172731 | VA | N | Nursing Service Providers | Registered Nurse | 163WX0800X | 0001172731 | VA | Y | Nursing Service Providers | Registered Nurse | Orthopedic |
No ID Information.