Provider Demographics
NPI:1902170640
Name:STEFANEK, TEANNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:TEANNA
Middle Name:
Last Name:STEFANEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 CRESCENT AVE UNIT 105
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7400
Mailing Address - Country:US
Mailing Address - Phone:541-556-6340
Mailing Address - Fax:
Practice Address - Street 1:2940 CRESCENT AVE UNIT 105
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7400
Practice Address - Country:US
Practice Address - Phone:541-556-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201142747163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health