Provider Demographics
NPI:1144437849
Name:ROSS, TERESA ELIZABETH (RN)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ELIZABETH
Last Name:ROSS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 GABLES DRIVE
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-2083
Mailing Address - Country:US
Mailing Address - Phone:352-383-9236
Mailing Address - Fax:
Practice Address - Street 1:2407 GABLES DR
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-2083
Practice Address - Country:US
Practice Address - Phone:352-383-9236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1424082163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health