MEDICARE: TERESA L VINSON NP

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
1	363L00000X	Nurse Practitioner	RN241988	GA

General Provider Information

NPI Number	:	1841863156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA L VINSON NP

Provider Business Mailing Address
First Line	:	2750 EXECUTIVE PARK NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-2722
Country	:	US
Telephone Number	:	502-234-9749
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 EXECUTIVE PARK NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-2722
Country	:	US
Telephone Number	:	423-476-4444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2021
Last Update Date	:	09/30/2025

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