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General NPI Number Information
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NPI Number | 1467647644
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Entity Type | Individual
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Provider Name | TERESA INMAN POND NNP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 830 KEMPSVILLE ROAD
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City | NORFOLK
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State | VA
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Zip | 23502-3920
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Country | US
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Telephone | 757-261-6057
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Fax | 757-261-6444
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Provider Business Mailing Address
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Address Line | 1625 HYDENWOOD CRESCENT
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City | CHESAPEAKE
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State | VA
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Zip | 23321-1811
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Country | US
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Telephone | 757-567-4880
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Fax | 757-261-6444
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 0024072671
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License Number State | VA
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