Provider Demographics
NPI:1346259454
Name:WEEKS, TERESA A (FNP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:WEEKS
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 1:6140 W CURTISIAN AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8907
Mailing Address - Country:US
Mailing Address - Phone:208-327-5600
Mailing Address - Fax:208-327-5602
Practice Address - Street 1:6140 W CURTISIAN AVE STE 400
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8907
Practice Address - Country:US
Practice Address - Phone:208-327-5600
Practice Address - Fax:208-327-5602
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-501A363L00000X, 363LF0000X
IDN1799363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1346259454Medicaid
WA0178519OtherWA DEPARTMENT OF LABOR
ID806347900Medicaid
ID000010139552OtherREGENCE BLUE SHIELD
OR57633OtherOMAP
057633OtherODS
ID8J711OtherBLUE CROSS GROUP
ID8J711OtherBLUE CROSS GROUP
ID1343557Medicare PIN
ID806347900Medicaid