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General NPI Number Information
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NPI Number | 1366802399
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Entity Type | Individual
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Provider Name | TERESA HEGWOOD FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 5901 CHASE RD STE 210
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City | DEARBORN
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State | MI
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Zip | 48126-0900
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Country | US
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Telephone | 832-869-4818
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Fax | 832-241-2902
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Provider Business Mailing Address
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Address Line | 393 ROOSEVELT AVE E
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City | BATTLE CREEK
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State | MI
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Zip | 49017-3333
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Country | US
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Telephone | 269-215-1253
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Fax | 577-733-4806
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 848359
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704302567
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704302567
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71014488A
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License Number State | IN
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