Provider Demographics
NPI:1689123093
Name:EMENECKER, TERESA (FNP, MSN)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:EMENECKER
Suffix:
Gender:F
Credentials:FNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9796 PECAN HICKORY WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-3605
Mailing Address - Country:US
Mailing Address - Phone:480-766-8183
Mailing Address - Fax:
Practice Address - Street 1:6000 TURKEY LAKE RD STE 205
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4206
Practice Address - Country:US
Practice Address - Phone:407-649-1848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9424121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily