MEDICARE: TERESE BARR NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F331150	NY
2	363LF0000X	Family Nurse Practitioner	ARNP9390518	FL

General Provider Information

NPI Number	:	1033115399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESE BARR NP

Provider Business Mailing Address
First Line	:	1300 SW SAINT LUCIE WEST BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-2109
Country	:	US
Telephone Number	:	772-878-7078
Fax Number	:	866-389-2727

Provider Business Practice Location Address
First Line	:	1300 SW SAINT LUCIE WEST BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-2109
Country	:	US
Telephone Number	:	772-878-7078
Fax Number	:	866-389-2727

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/18/2020

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