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Individual

MRS. TERESA JEAN HAIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, CNOR, RNFA

Contact information

Practice address
1000 WATERMAN WAY, TAVARES, FL 32778-5266
(352) 253-3457
Mailing address
1414 E WASHINGTON AVE, EUSTIS, FL 32726-5072
(352) 357-1543

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN1966832
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
052807
CERTIFICATION I.D.
FL
01
RN1966832
LICENSURE NUMBER
FL
Enumeration date
10/29/2006
Last updated
07/08/2007
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