| Doctor Name: | MR. KEVIN M TEEL |
| NPI Number: | 1043515034 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | 2011000642 |
| Business Practice Address: | 2829 S. Jackson Avenue Joplin, MO - 64804 |
| Business Phone Number: | 4176240440 |
| Business Fax Number: | 4176249652 |
| Mailing Address: | 2829 S. Jackson Avenue, JOPLIN |
| State: | MO |
| Postal Code: | 64804 |
| Phone Number: | 4176240440 |
| Fax Number: | 4176249652 |
| NPI Enumeration Date: | 01/21/2011 |
| NPI Last Update Date: | 09/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2011000642 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |