Provider Demographics
NPI:1194517706
Name:STILLER, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:STILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6630 STILLMEAD DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-5906
Mailing Address - Country:US
Mailing Address - Phone:937-623-4919
Mailing Address - Fax:
Practice Address - Street 1:250 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-4059
Practice Address - Country:US
Practice Address - Phone:937-623-4919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant