Healthcare Provider Details

I. General information

NPI: 1083678866
Provider Name (Legal Business Name): TERESA WINSLOW FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 01/18/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HOSPITAL DRIVE VIDANT EDGECOMBE HOSPITAL
TARBORO NC
27886
US

IV. Provider business mailing address

PO BOX 751069
CHARLOTTE NC
28275-1069
US

V. Phone/Fax

Practice location:
  • Phone: 252-641-7150
  • Fax: 252-641-7477
Mailing address:
  • Phone: 252-744-3253
  • Fax: 252-744-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number000201850
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: