Leah Tedder

Physician Assistant · Niceville, FL

Individual Active NPI

NPI number 1093045569

Practice location

2190 Highway 85 N
Niceville, FL 32578-1045
Phone
(850) 729-9490

Open in Google Maps

NPI record

NPI
1093045569
Entity type
Individual (Type 1)
Enumeration date
January 6, 2010
Last updated
August 12, 2024
Certified
August 12, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X PA9105931 FL
Physician Assistant 363A00000X — —
Surgical Physician Assistant 363AS0400X 9105931 FL

Mailing address

4242 Jade Loop
Destin, FL 32541-5134
Phone
(808) 554-7640

About Leah Tedder

Leah Tedder is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 2190 Highway 85 N, Niceville, FL 32578-1045. The NPI number 1093045569 was assigned on January 6, 2010 and the record was last updated on August 12, 2024.

Leah Tedder lists 2 licenses in the registry: #PA9105931 (FL) for Physician Assistant; #9105931 (FL) for Surgical Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Leah Tedder?

The NPI number is 1093045569.

What is the phone number of Leah Tedder?

The phone number listed for the practice location is (850) 729-9490.

Where is Leah Tedder located?

2190 Highway 85 N, Niceville, FL 32578-1045.

What is the taxonomy code for Leah Tedder?

The primary taxonomy code is 363A00000X – Physician Assistant; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Physician Assistant providers in Niceville

All Physician Assistant providers in Niceville, FL →