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NPI Code Detail

MEDICARE: MS. TERESA LYNN ANDERSON FNP

MEDICARE: MS. TERESA LYNN ANDERSON FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner200460NC
2363L00000XNurse Practitioner200460NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699984823
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TERESA LYNN ANDERSON FNP
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 336-643-5800
Fax Number : 336-643-7474
Provider Business Practice Location Address
First Line : 6161 LAKE BRANDT RD UNIT B
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-8415
Country : US
Telephone Number : 336-643-5800
Fax Number : 336-643-7474
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 12/19/2023

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