# TERESA ANN WENNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1871278747
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WM1400X | Nurse Massage Therapist (NMT) | 0001149304 | VA | — |
| 163WM1400X | Nurse Massage Therapist (NMT) | 53092 | WV | Yes |
| 163WW0101X | Ambulatory Women's Health Care Registered Nurse | 53092 | WV | — |
| 225700000X | Massage Therapist | 0019019311 | VA | — |
| 225700000X | Massage Therapist | 223-4023 | WV | — |

## Other

- **Enumeration date:** 06/19/2023
- **Last updated:** 06/19/2023