Healthcare Provider Details

I. General information

NPI: 1629740204
Provider Name (Legal Business Name): TEAWNA HEMPHILL FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TEAWNA HEMPHILL-ASHLEY FNP-BC, PMHNP-BC

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 MAIN ST
WILLIAMSVILLE NY
14221-5776
US

IV. Provider business mailing address

144 GENESEE ST
BUFFALO NY
14203-1560
US

V. Phone/Fax

Practice location:
  • Phone: 716-201-0511
  • Fax:
Mailing address:
  • Phone: 716-310-8424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number347146
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407644
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: