Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | ARNP1738412 | FL |
NPI | 1144423989 |
---|---|
Provider Name | Mrs. Teresa Stacy Mcpherson |
First Address | Melbourne Beach, FL 32951-2531 |
Second Address | Plant City, FL 33563-4303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 09/07/2007 |