| Doctor Name: | TERESA SUE THORPE |
| NPI Number: | 1124245493 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | NP 07109 |
| Business Practice Address: | 2912 Springboro Rd West Suite 201 Moraine, OH - 454391674 |
| Business Phone Number: | 9372978999 |
| Business Fax Number: | |
| Mailing Address: | 1671 N Laddie Ct, BEAVERCREEK |
| State: | OH |
| Postal Code: | 454322456 |
| Phone Number: | 9374261032 |
| Fax Number: | |
| NPI Enumeration Date: | 04/19/2007 |
| NPI Last Update Date: | 08/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | NP 07109 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |