Healthcare Provider Details

I. General information

NPI: 1871241448
Provider Name (Legal Business Name): TERESA KATHLEEN HOCKING FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5560 STATE HWY 100 SUITE 107
PALM COAST FL
32164
US

IV. Provider business mailing address

2620 ELM HILL PIKE
NASHVILLE TN
37214-3108
US

V. Phone/Fax

Practice location:
  • Phone: 386-225-4631
  • Fax:
Mailing address:
  • Phone: 615-425-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71012316A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: