Individual
TERI MUHS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-2590
Mailing address
DEPT CH 17767, PALATINE, IL 60055-0001
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704225682
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4518136
—
MI
01
—
P00205532
RAILROAD MEDICARE
—
01
—
TK201152
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/23/2005
Last updated
12/28/2024
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