Provider Demographics
NPI:1326156712
Name:AMENT, TERESA A (ARNP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:A
Last Name:AMENT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 WINTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2530
Mailing Address - Country:US
Mailing Address - Phone:615-444-4300
Mailing Address - Fax:
Practice Address - Street 1:1404 WINTER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2530
Practice Address - Country:US
Practice Address - Phone:615-444-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13222363LP0808X
KY5047P363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326156712OtherNPI
Q71831OtherUPIN
TN1512314Medicaid
TN33417991OtherMEDICARE