TERESA RAYBOURN (NPI# 1992782304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992782304 |
| Entity Type | Individual |
| Full Name | TERESA RAYBOURN |
| Other Name | TERESA HOLIFIELD |
| Credential | FNP-BC |
| Practice Address |
226 Whiteoak Ave Raleigh MS 39153-6082 |
| Mailing Address |
Po Box 24116 Jackson MS 39225-4116 |
| Practice Telephone | 6018257280 |
| Practice Fax Number | 6018258130 |
| Mailing Telephone | 6018257280 |
| Mailing Fax Number | 6018258130 |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2016-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R746931 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | RAILROAD MEDICARE | P00872423 | 01 |
| MS | 00119934 | 05 |
| Street Address |
226 WHITEOAK AVE |
| City | RALEIGH |
| State | MS |
| Zip Code | 39153-6082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252435 | Vaniecia Wilson | Dentist | 226 Whiteoak Ave, Raleigh, MS 39153-6082 | 2020-07-15 |
| 1861970246 | Olha Mckay | Dentist | 226 Whiteoak Ave, Raleigh, MS 39153-6082 | 2018-07-30 |
| 1639414923 | Ann Blackwell | Dietitian, Registered | 226 Whiteoak Ave, Raleigh, MS 39153-6082 | 2012-11-28 |
| 1609013226 | Carol Darlene Richmond-stephens | Licensed Practical Nurse | 226 Whiteoak Ave, Raleigh, MS 39153-6082 | 2009-01-20 |
| 1588853154 | Family Health Care Clinic, Inc. | Clinic/Center | 226 Whiteoak Ave, Raleigh, MS 39153 | 2007-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780936740 | Heather Celeste Burt Jordan | Occupational Therapist | 309 Magnolia Road, Rolling Acres Retirement, Raleigh, MS 39153 | 2012-10-15 |
| 1831484609 | Lane Napier Baxter | Dentist | 226 Highway 18 West, Raleigh, MS 39153 | 2011-06-09 |
| 1568626216 | Guardian Angel Healthcare Inc., II | Medicare Defined Swing Bed Unit | 347 Magnolia Drive, Raleigh, MS 39153 | 2008-07-11 |
| 1326178203 | Smith County Ltc, LLC | Nursing Facility/Intermediate Care Facility | 309 Magnolia Drive, Raleigh, MS 39153 | 2007-03-07 |
| 1386705705 | Phil Thompson | Family Medicine | 342 Magnolia Drive, Raleigh, MS 39153 | 2006-12-12 |
| 1962599696 | Bobby D Maddox | Dentist | 207 Sylvarena Ave., Raleigh, MS 39153 | 2006-10-06 |
| 1679660492 | Raleigh Dental Clinic | Dentist | 207 Sylvarena Ave, Raleigh, MS 39153 | 2006-10-05 |
| 1538278734 | Larry Franklin Gibson | Family Medicine | 202 Sylvarena Ave., Raleigh, MS 39153 | 2006-08-30 |
| 1285967653 | Guardian Angel Healthcare Inc., II | Psychiatric Unit | 347 Magnolia Drive, Raleigh, MS 39153 | 2009-09-16 |
| 1811181407 | Guardian Angel Healthcare Inc., II | General Acute Care Hospital | 347 Magnolia Dr, Raleigh, MS 39153 | 2007-08-28 |
| Find all providers in zip 39153 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558990 | Munira Amirali Ward | Nurse Practitioner | 2617 Valley Haven Dr, Raleigh, NC 27603-3197 | 2020-11-03 |
| 1710598644 | Nicole Dora Licato | Nurse Practitioner | 7200 Creedmoor Rd Ste 208, Raleigh, NC 27613-1711 | 2020-08-13 |
| 1316561178 | Mintoria Lynette Stockton | Nurse Practitioner | 8332 Mcguire Dr, Raleigh, NC 27616-5682 | 2020-06-07 |
| 1700407103 | Sadonna Marlene Sawyer | Nurse Practitioner | 3311 Grove Crabtree Cres Apt 122, Raleigh, NC 27613-3063 | 2020-04-27 |
| 1447879903 | Christapher Frank | Nurse Practitioner | 2034 Wesvill Court, Suite 320, Raleigh, NC 28326 | 2020-04-14 |
| 1265065015 | Shubham Tyagi | Nurse Practitioner | Duke Urgent Care Brier Creek, 10211 Alm Street Suite 1200, Raleigh, NC 27617-2761 | 2020-02-20 |
| 1073163812 | Taylor Brooke Lawrence | Nurse Practitioner | 10208 Cerny St Ste 301, Raleigh, NC 27617-1000 | 2019-09-13 |
| 1811456320 | Elizabeth Campbell Mcgrath | Nurse Practitioner | 2615 Lake Dr Ste 201, Raleigh, NC 27607-6694 | 2019-03-14 |
| 1922578541 | Dorothy Nwizu | Nurse Practitioner | 608 Kavkaz St, Raleigh, NC 27610-3176 | 2018-11-26 |
| 1265900013 | Patricia-marie Edge Odom | Nurse Practitioner | 3000 New Bern Ave Ste G100, Raleigh, NC 27610-1231 | 2018-11-09 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on TERESA RAYBOURN.
| 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.