Provider Demographics
NPI:1598982266
Name:BLATT, TERESA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:BLATT
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:PO BOX 1244
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-7244
Mailing Address - Country:US
Mailing Address - Phone:272-224-1604
Mailing Address - Fax:570-628-5298
Practice Address - Street 1:21 S CENTRE ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3014
Practice Address - Country:US
Practice Address - Phone:272-224-1604
Practice Address - Fax:570-628-5298
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP014861363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health