Provider Demographics
NPI:1558958272
Name:MILLERSCHOEN, THERESA ANN (RN, PMHNP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:MILLERSCHOEN
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 KING JAMES LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-2434
Mailing Address - Country:US
Mailing Address - Phone:732-267-6942
Mailing Address - Fax:
Practice Address - Street 1:40 E 30TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7374
Practice Address - Country:US
Practice Address - Phone:212-810-4120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY692443-01163WS0200X
NYF405157-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool