Provider Demographics
NPI:1235452400
Name:WESTENBARGER, TERI A (APRN)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:A
Last Name:WESTENBARGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:CAIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-6860
Mailing Address - Fax:239-343-5179
Practice Address - Street 1:9981 S HEALTHPARK DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3618
Practice Address - Country:US
Practice Address - Phone:239-343-6860
Practice Address - Fax:239-985-3528
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9288224363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002397700Medicaid