Provider Demographics
NPI:1609676477
Name:TETSCHNER, TERREL KEITH
Entity type:Individual
Prefix:
First Name:TERREL
Middle Name:KEITH
Last Name:TETSCHNER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12875 DEAUVILLE DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3242
Mailing Address - Country:US
Mailing Address - Phone:402-399-1700
Mailing Address - Fax:402-393-0883
Practice Address - Street 1:12875 DEAUVILLE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3242
Practice Address - Country:US
Practice Address - Phone:402-399-1700
Practice Address - Fax:402-393-0883
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE54249163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator