Provider Demographics
NPI:1083678866
Name:WINSLOW, TERESA (FNP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:252-744-3253
Mailing Address - Fax:252-744-3194
Practice Address - Street 1:111 HOSPITAL DRIVE
Practice Address - Street 2:VIDANT EDGECOMBE HOSPITAL
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886
Practice Address - Country:US
Practice Address - Phone:252-641-7150
Practice Address - Fax:252-641-7477
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000201850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003656Medicaid
NC2592067AMedicare ID - Type Unspecified
NCQ16210Medicare UPIN