Provider Demographics
NPI:1558958272
Name:MILLERSCHOEN, THERESA ANN (RN, PMHNP)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:MILLERSCHOEN
Suffix:
Gender:F
Credentials:RN, PMHNP
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Mailing Address - Street 1:9 HEDDEN PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-3611
Mailing Address - Country:US
Mailing Address - Phone:201-614-3446
Mailing Address - Fax:
Practice Address - Street 1:35 E 21ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6212
Practice Address - Country:US
Practice Address - Phone:212-810-4120
Practice Address - Fax:732-401-9257
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY692443-01163WS0200X
NJ26NJ15021500363LP0808X
NYF405157-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool