MEDICARE: TERESA WELLS SMITH ARNP

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	201973	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1932108099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA WELLS SMITH ARNP

Provider Business Mailing Address
First Line	:	3355 BEAR GRASS RD
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-8277
Country	:	US
Telephone Number	:	252-809-6400
Fax Number	:	252-809-6409

Provider Business Practice Location Address
First Line	:	521 MOYE BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-2849
Country	:	US
Telephone Number	:	252-744-1600
Fax Number	:	252-744-1115

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	03/06/2025

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