Provider Demographics
NPI:1033947544
Name:TELLER, MADELINE MURRAY (BSN-RN, CDCES)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:MURRAY
Last Name:TELLER
Suffix:
Gender:F
Credentials:BSN-RN, CDCES
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:MURRAY
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42 MAY ST
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03748-3024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR # 6M
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-653-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH112804-21163W00000X
IL041533492163W00000X
IL32300974163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163W00000XNursing Service ProvidersRegistered Nurse