Provider Demographics
NPI:1891754552
Name:WEISBERGER, TERI M (RN,FNP-BC)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:M
Last Name:WEISBERGER
Suffix:
Gender:F
Credentials:RN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SNARE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:JONESPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04649-3139
Mailing Address - Country:US
Mailing Address - Phone:207-497-5614
Mailing Address - Fax:207-497-5554
Practice Address - Street 1:70 SNARE CREEK LN
Practice Address - Street 2:
Practice Address - City:JONESPORT
Practice Address - State:ME
Practice Address - Zip Code:04649-3139
Practice Address - Country:US
Practice Address - Phone:207-497-5614
Practice Address - Fax:207-497-5554
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER019915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MES23055Medicare UPIN