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General NPI Number Information
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NPI Number | 1336288679
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Entity Type | Individual
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Provider Name | TERESA H MCCORMICK CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 6101 PINE RIDGE RD
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City | NAPLES
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State | FL
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Zip | 34119-3900
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Country | US
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Telephone | 239-304-4716
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 SOLANA BLVD STE 2200
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City | WESTLAKE
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State | TX
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Zip | 76262-1769
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Country | US
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Telephone | 610-716-1385
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN293519L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN9470120
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License Number State | FL
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