Healthcare Provider Details

I. General information

NPI: 1336649144
Provider Name (Legal Business Name): TERESA PIERRE MCDOWALL NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11029 LEMAY DR
CLERMONT FL
34711-8071
US

IV. Provider business mailing address

PO BOX 120268
CLERMONT FL
34712-0268
US

V. Phone/Fax

Practice location:
  • Phone: 917-353-7139
  • Fax:
Mailing address:
  • Phone: 352-670-3929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9173370
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9173370
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCNP261094
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number53-85146-072
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9173370
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number101.0138385TELE
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: