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General NPI Number Information
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NPI Number | 1598392375
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Entity Type | Individual
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Provider Name | TESHEIKA NAVOY BOOMER FNP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 203 CROCKETT RIDGE CT E
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City | RICHLANDS
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State | NC
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Zip | 28574-7471
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Country | US
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Telephone | 910-650-6592
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Fax | 910-597-1689
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Provider Business Mailing Address
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Address Line | 203 CROCKETT RIDGE CT E
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City | RICHLANDS
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State | NC
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Zip | 28574-7471
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Country | US
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Telephone | 910-650-6592
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Fax | 910-597-1689
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F12190403
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2022091499
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License Number State | NC
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