| Doctor Name: | MS. KACIE MILLER TEETER |
| NPI Number: | 1063567626 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 001000789 |
| Business Practice Address: | 310 Davie Ave Statesville Family Practice Statesville, NC - 286775319 |
| Business Phone Number: | 7048733269 |
| Business Fax Number: | 7048718159 |
| Mailing Address: | 310 Davie Ave, Statesville Family Practice STATESVILLE |
| State: | NC |
| Postal Code: | 286775319 |
| Phone Number: | 7048733269 |
| Fax Number: | 7048718159 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 07/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 001000789 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |