Provider Demographics
NPI:1033110077
Name:RITCHIE, TERESA D (FNP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:D
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:D
Other - Last Name:DANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:186 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26147-7100
Mailing Address - Country:US
Mailing Address - Phone:304-354-9244
Mailing Address - Fax:304-354-9323
Practice Address - Street 1:186 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26147-7100
Practice Address - Country:US
Practice Address - Phone:304-354-9244
Practice Address - Fax:304-354-9323
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV26326363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7104123-000Medicaid
WV7104123-000Medicaid
RINP76401Medicare ID - Type Unspecified