Most Relevant Information
Provider Data
| NPI Number: | 1003806951 |
| Provider Name: | COLETTE M TETREAULT CNM |
| Entity Type: | Individual |
| Taxonomy Code: | 367A00000X |
| Specialty: | Advanced Practice Midwife |
| License Number: | RN150205 |
Most Important Dates
| Enumeration Date: | 10/24/2005 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1700 HOSPITAL SOUTH DR
SUITE 500
AUSTELL
GA
301066810
Practice Location Phone/Fax
| Phone: | 7709417717 |
| Fax: | 7709489729 |
Provider Mailing Location
1700 HOSPITAL SOUTH DR
SUITE 500
AUSTELL
GA
301066810
Provider Mailing Phone/Fax
| Phone: | 7709417717 |
| Fax: | 7709489729 |