Provider Demographics
NPI:1003089921
Name:ANDERSON, TERESA MARY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:MARY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:TERESA
Other - Middle Name:MARY
Other - Last Name:VERNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2505 YORKDALE CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3875
Mailing Address - Country:US
Mailing Address - Phone:919-490-1575
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:CB 7600
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-2457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC184901835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy