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General NPI Number Information
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NPI Number | 1700691714
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Entity Type | Individual
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Provider Name | TERESE A POLING FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2025
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 70 W HONEY CREEK PKWY
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City | TERRE HAUTE
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State | IN
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Zip | 47802-6700
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Country | US
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Telephone | 812-234-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 858 N LASALLE ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46201-2556
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Country | US
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Telephone | 317-907-4198
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | ME108693
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 49062
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License Number State | IN
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