Healthcare Provider Details

I. General information

NPI: 1700755261
Provider Name (Legal Business Name): TERI PEARSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 MAIN ST
POINT PLEASANT WV
25550-1119
US

IV. Provider business mailing address

PO BOX 707
GALLIPOLIS OH
45631-0707
US

V. Phone/Fax

Practice location:
  • Phone: 304-812-5443
  • Fax: 304-812-5443
Mailing address:
  • Phone: 740-441-1377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number122585
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: