TERESA M WALLACE (NPI# 1225357635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225357635 |
| Entity Type | Individual |
| Full Name | TERESA M WALLACE |
| Credential | APN0000014863 |
| Practice Address |
1880 Old Highway 51 S Ste C Brighton TN 38011-8025 |
| Practice Telephone | 9018377979 |
| Practice Fax Number | 9018377999 |
| Mailing Telephone | 9018377979 |
| Mailing Fax Number | 9018377999 |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2016-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000014863 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235600081 | Teresa Wallace | Licensed Practical Nurse | 2 Rifkin Ct, Spring Valley, NY 10977-2236 | 2018-12-05 |
| 1417026402 | Teresa H. Wallace | Speech-Language Pathologist | 1511 Copper Creek Dr, Owensboro, KY 42303-1797 | 2006-11-06 |
| 1154966984 | Teresa Michelle Wallace | Behavior Technician | 1941 S 42nd St Ste 328, Omaha, NE 68105-2943 | 2019-11-15 |
| 1871509646 | Teresa L Wallace | Family Medicine | 3915 Talbot Rd S, Ste 401, Renton, WA 98055-5738 | 2006-07-31 |
| 1497709703 | Teresa Wallace | Audiologist | 1700 S Lincoln Ave, Lebanon, PA 17042-7529 | 2006-05-20 |
| Street Address |
1880 OLD HIGHWAY 51 S STE C |
| City | BRIGHTON |
| State | TN |
| Zip Code | 38011-8025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558492306 | Jenipher E Chaney | Family Medicine | 1880 Old Hwy 51 Suite C, Brighton, TN 38011 | 2007-03-07 |
| 1376583096 | Charles L Porter | Pharmacist | 1880 Old Hwy 51, Brighton, TN 38011 | 2006-06-08 |
| 1679567390 | Brighton Family Medicine | Family Medicine | 1880 Old Hwy 51, Suite C, Brighton, TN 38011 | 2005-09-08 |
| 1467566885 | Brighton Medical Practice | Specialist | 39 W Woodlawn Ave, Brighton, TN 38011-4139 | 2006-08-19 |
| 1033212667 | John Raymond Hughey | Specialist | 39 W Woodlawn Ave, Brighton, TN 38011-4139 | 2006-09-07 |
| 1164594081 | West Clinic PC | Specialist | 240 Grandview Drive, Brighton, TN 38011-4253 | 2006-11-15 |
| 1528364874 | Kimberly Ann Rowland | Registered Nurse | 77 Fannie Dr, Brighton, TN 38011-6287 | 2011-02-03 |
| 1316485733 | Jared Vowell | Specialist/Technologist | 751 Roseland Dr, Brighton, TN 38011-6315 | 2017-02-06 |
| 1326099045 | Charles Michael Putnam | Social Worker | 74 Sanders Dr, Brighton, TN 38011-6501 | 2006-05-15 |
| 1780929349 | Michael Dalen Jaureque | Chore Provider | 159 Hilltop Cir, Brighton, TN 38011-6628 | 2012-12-06 |
| Find all providers in zip 38011 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295145 | Heather Thomas | Nurse Practitioner | 39 Brock St Apt 1, Brighton, MA 02135-2661 | 2020-11-03 |
| 1912512591 | Ariel Caprice Lewis | Nurse Practitioner | 2228 Cobblestone Ln, Brighton, MI 48114-7347 | 2020-09-10 |
| 1992320212 | Caitlin Marie Hussey | Nurse Practitioner | 14 Colborne Rd Apt 5, Brighton, MA 02135-4830 | 2020-06-12 |
| 1346873197 | Destiny Lashay Woodard | Nurse Practitioner | 10070 Mcquiston Rd, Brighton, TN 38011-7004 | 2020-02-20 |
| 1013540350 | Tina Yiu | Nurse Practitioner | 42 Euston Rd, Brighton, MA 02135-4805 | 2020-02-14 |
| 1275183907 | Irina Shvets | Nurse Practitioner | 27 Glenmont Rd, Brighton, MA 02135-3145 | 2019-09-15 |
| 1366911687 | Emily Hoeft | Nurse Practitioner | 8246 Hillside Lakes Dr, Brighton, MI 48116-8297 | 2018-11-15 |
| 1073944781 | Patrice Noel | Nurse Practitioner | 11 Nevins St Ste 303, Brighton, MA 02135-3514 | 2013-12-05 |
| 1487094785 | Sara Kallio Becker | Nurse Practitioner | 191 Telluride St Unit 5, Brighton, CO 80601-4356 | 2013-07-01 |
| 1811271448 | Kathryn Grace Victor | Nurse Practitioner | 2 Sutherland Rd, Unit 33, Brighton, MA 02135-7028 | 2011-09-30 |
| Find all providers in BRIGHTON | ||||
Please comment or provide details below to improve the information on TERESA M WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.