Provider Demographics
NPI:1730200577
Name:TUCHEK, TERESA ANN (MA, RD, CD)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:TUCHEK
Suffix:
Gender:F
Credentials:MA, RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 GRAYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-4470
Mailing Address - Country:US
Mailing Address - Phone:317-627-2133
Mailing Address - Fax:317-788-7878
Practice Address - Street 1:6750 GRAYBROOK DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-4470
Practice Address - Country:US
Practice Address - Phone:317-627-2133
Practice Address - Fax:317-788-7878
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered