Provider Demographics
NPI:1083732911
Name:HUG, TERESA CAROL (APN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:CAROL
Last Name:HUG
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:CAROL
Other - Last Name:LEGGETT/RUTLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:9209 SEMINOLE BLVD UNIT 105
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-3123
Mailing Address - Country:US
Mailing Address - Phone:901-596-6758
Mailing Address - Fax:
Practice Address - Street 1:9209 SEMINOLE BLVD UNIT 105
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-3123
Practice Address - Country:US
Practice Address - Phone:901-596-6758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007496363LA2100X
TX1136507363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNS82245Medicare UPIN