Provider Demographics
NPI:1619597226
Name:BARNES, TERESA EDWARDS (RN)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:EDWARDS
Last Name:BARNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 OLD US HIGHWAY 74
Mailing Address - Street 2:
Mailing Address - City:CHADBOURN
Mailing Address - State:NC
Mailing Address - Zip Code:28431-7137
Mailing Address - Country:US
Mailing Address - Phone:910-770-0470
Mailing Address - Fax:
Practice Address - Street 1:180 SOUTHWOOD DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-5002
Practice Address - Country:US
Practice Address - Phone:910-592-8165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97741163W00000X
NC5013554363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse