| Doctor Name: | MS. CAROL A TEAGUE |
| NPI Number: | 1477625531 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 076310 |
| Business Practice Address: | 1000 N Jefferson St St James, MO - 65401 |
| Business Phone Number: | 5732658840 |
| Business Fax Number: | 5732658884 |
| Mailing Address: | Po Box 579, ROLLA |
| State: | MO |
| Postal Code: | 65402 |
| Phone Number: | 5734588228 |
| Fax Number: | 5734265314 |
| NPI Enumeration Date: | 11/14/2006 |
| NPI Last Update Date: | 09/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 076310 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |