Provider Demographics
NPI:1255438818
Name:RASHDAN, THERESA YVONNE GRAY (MSN, CPNP-PC/AC, FNP)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:YVONNE GRAY
Last Name:RASHDAN
Suffix:
Gender:F
Credentials:MSN, CPNP-PC/AC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 127TH TERRACE E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219
Mailing Address - Country:US
Mailing Address - Phone:941-776-3579
Mailing Address - Fax:
Practice Address - Street 1:301 N ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4303
Practice Address - Country:US
Practice Address - Phone:941-685-0918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA238039363LA2100X
FLARNP9322046363LF0000X, 363LP0200X, 363LP0222X
TX608590363LP0200X, 363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics