Healthcare Provider Details

I. General information

NPI: 1114263373
Provider Name (Legal Business Name): TERESA MORGAN DILLINGER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2012
Last Update Date: 12/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 S MAIN ST
MIDDLETON TN
38052-3607
US

IV. Provider business mailing address

727 S MAIN ST
MIDDLETON TN
38052-3607
US

V. Phone/Fax

Practice location:
  • Phone: 731-472-2072
  • Fax: 731-472-2079
Mailing address:
  • Phone: 731-472-2072
  • Fax: 731-472-2079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20487
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: