Provider Demographics
NPI:1043077084
Name:TEKELU, GENET B (FNP)
Entity type:Individual
Prefix:
First Name:GENET
Middle Name:B
Last Name:TEKELU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:GENET
Other - Middle Name:B
Other - Last Name:TEKELU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:747 LILLY LANDING LN
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-7052
Mailing Address - Country:US
Mailing Address - Phone:614-957-6438
Mailing Address - Fax:
Practice Address - Street 1:3805 EMERALD PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3317
Practice Address - Country:US
Practice Address - Phone:614-665-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035583363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care