MISS TERESA MICHELLE WATTS


Address: 900 Main St, Suite 100, Peoria, IL 61602-1005
Phone: 3096724908

MISS TERESA MICHELLE WATTS (NPI# 1407223969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407223969
Entity Type Individual
Full Name MISS TERESA MICHELLE WATTS
Practice Address 900 Main St
Suite 100
Peoria
IL 61602-1005
Mailing Address 1707 W Viking Ct
Apt 301
Peoria
IL 61614-1565
Practice Telephone 3096724908
Mailing Telephone 3097060394
Enumeration Date 2015-08-31
Last Update Date 2015-08-31
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
209.013239 IL Physician Assistants & Advanced Practice Nursing Providers

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Office Location

Street Address 900 MAIN ST
SUITE 100
City PEORIA
State IL
Zip Code 61602-1005

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295260784 Alexandra Gens Psychiatry & Neurology 900 Main St, Suite 720, Peoria, IL 61602-1005 2017-04-22
1407380751 Unitypoint Health Methodist Psychiatry & Neurology 900 Main St, Suite 720, Peoria, IL 61602-1005 2017-04-13
1669823068 Kory Jackson Nurse Practitioner 900 Main St, Ste 100, Peoria, IL 61602-1005 2016-06-27
1932554714 Jamie Schupbach Nurse Practitioner 900 Main St, Ste 600, Peoria, IL 61602-1005 2016-04-28
1487054433 Christina Lowrance Nurse Practitioner 900 Main St, Peoria, IL 61602-1005 2014-08-27
1295158194 Karolina Wozny Physician Assistant 900 Main St, Suite 630, Peoria, IL 61602-1005 2014-01-28
1821423583 Radha K Chathadi Registered Nurse 900 Main St, Suite 630, Peoria, IL 61602-1005 2013-09-12
1558796789 Erin Surratt Social Worker 900 Main St, Suite 400, Peoria, IL 61602-1005 2013-09-06
1336490333 Susan Copp Nurse Practitioner 900 Main St, Suite 600, Peoria, IL 61602-1005 2012-10-01
1831440395 Lydia Bertschi Nurse Practitioner 900 Main St, Suite 630, Peoria, IL 61602-1005 2012-09-25
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720574676 Critical Care Rx, LLC Pharmacy 126 Oak St, Peoria, IL 61602 2018-07-03
1235675836 Cheryl Beckman Registered Nurse 211 Fulton Street, Suite 207, One Technology Plaza, Peoria, IL 61602 2017-01-06
1063957942 Rosemary Ince Registered Nurse 211 Fulton St. Suite 207, One Technology Plaza, Peoria, IL 61602 2016-12-30
1962674820 Lisa Jean Burckhartzmeyer Psychiatry & Neurology 228 Ne Jefferson St, Peoria, IL 61602 2008-03-31
1669503587 Jill Larson Counselor 330 Sw Washington Street, Peoria, IL 61602 2007-03-09
1265407399 Cardiac Consultants Sc Internal Medicine 900 Main Street, Suite 320, Peoria, IL 61602 2006-02-22
1013364470 Rafal Szymczuk Student in an Organized Health Care Education/Training Program 900 Main Street, Suite 720, Peoria, IL 61602 2016-05-16
1043693831 Kari Beth Watts Family Medicine 815 Main St, Peoria, IL 61602 2015-06-30
1881072791 Kristen Dent Family Medicine 815 Main St, Peoria, IL 61602 2015-05-12
1023422797 Andrew Wang Psychiatry & Neurology 900 Main St Ste 580, Peoria, IL 61602 2014-06-20
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1003170440 Diana Sun Bone Nurse Practitioner 9947 West Happy Valley Parkway, # 104, Peoria, AZ 85383-6001 2012-06-29
1851333819 Tina White Nurse Practitioner 1419 S Folkers Ave, Peoria, IL 61605-1356 2006-06-12
1457398265 Cheryl Kliot-lape Nurse Practitioner 800 W Romeo B Garrett Ave, Peoria, IL 61605-2207 2006-06-01
1083263503 Wellness for Life Family Practice Nurse Practitioner 20449 N Lake Pleasant Rd Ste 101, Peoria, AZ 85382-2707 2019-09-06
1366913618 Krishna Keshav Nurse Practitioner 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381 2018-12-16
1881912392 Jailson Souza Nascimento Nurse Practitioner 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 2010-05-07
1164561130 Amy Marie Davis Nurse Practitioner 5401 N Knoxville Ave Ste 207, Peoria, IL 61614-5021 2007-02-06
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Competitor

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City PEORIA
Zip Code 61602

Improve Information

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Dataset Information

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.

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