MEDICARE: TERESA ANN DUFFINA LPN

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	164W00000X	Licensed Practical Nurse	70039	NC

General Provider Information

NPI Number	:	1659267409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA ANN DUFFINA LPN

Provider Business Mailing Address
First Line	:	2501 SARASOTA CT
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-5945
Country	:	US
Telephone Number	:	919-609-9677
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 SARASOTA CT
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-5945
Country	:	US
Telephone Number	:	919-609-9677
Fax Number	:

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

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	06/17/2025

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