TERESA L ROBERTS (NPI# 1184911158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184911158 |
Entity Type | Individual |
Full Name | TERESA L ROBERTS |
Other Name | TERESA L BUSH |
Credential | PMHNP-BC |
Practice Address |
909 E State Blvd Fort Wayne IN 46805 |
Mailing Address |
909 E State Blvd Fort Wayne IN 46805-3404 |
Practice Telephone | 2604812700 |
Practice Fax Number | 2604812709 |
Mailing Telephone | 2604812700 |
Mailing Fax Number | 2604812709 |
Enumeration Date | 2011-06-29 |
Last Update Date | 2018-09-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
28195388A | IN | Nursing Service Providers |
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
71008269A | IN | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326420233 | Teresa Roberts | Speech-Language Pathologist | 3228 Se 59th Ave, Portland, OR 97206-2038 | 2015-06-26 |
1629466545 | Teresa Roberts | Registered Nurse | 700 Childrens Dr, Columbus, OH 43205-2664 | 2014-12-30 |
1306273479 | Teresa Gail Roberts | Registered Nurse | 8295 Tournament Dr Ste 150, Memphis, TN 38125-8900 | 2013-10-03 |
1427498211 | Teresa Jean Roberts | Specialist | 1 Plaza South St, Tahlequah, OK 74464-4750 | 2013-06-26 |
1689963258 | Teresa Roberts | Social Worker | 697 Louisiana Rd, Dyess Afb, TX 79607-1141 | 2011-04-04 |
1306040217 | Teresa L Roberts | Anesthesiology | 111 Michigan Ave Nw, Washington, DC 20010-2916 | 2007-06-13 |
1124177886 | Teresa Frances Roberts | Occupational Therapy Assistant | 143 Merrimon Ave, Asheville, NC 28801-1815 | 2007-01-10 |
Street Address |
909 E STATE BLVD |
City | FORT WAYNE |
State | IN |
Zip Code | 46805 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689664419 | Richard A Horstmeyer | Family Medicine | 909 E State Blvd, Fort Wayne, IN 46805-3404 | 2005-10-24 |
1174132674 | Rachel Lee Taykowski | Social Worker | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2020-07-30 |
1831708510 | Alexandra Leroy | Counselor | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2020-07-28 |
1881203560 | Timothy James Prentice | Counselor | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2020-07-28 |
1922617620 | Elise S. Beech | Social Worker | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2020-07-28 |
1457972481 | David D Hibish | Case Manager/Care Coordinator | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2020-04-30 |
1790317667 | Jill Elizabeth Surine | Counselor | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2020-02-10 |
1851923627 | Emily Redman | Counselor | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2020-02-10 |
1912537325 | Estrella Devia | Case Manager/Care Coordinator | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2020-01-24 |
1083252548 | Amber Ginet O'daniels | Counselor | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2019-12-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
Find all providers in zip 46805 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033742184 | Hamutyinei H Mamutse | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-02-18 |
1598395238 | Werner R Wolff | Nurse Practitioner | 700 Broadway, Fort Wayne, IN 46802-1402 | 2020-01-22 |
1083255855 | Melissa Ann Terry | Nurse Practitioner | 909 E State Blvd, Fort Wayne, IN 46805-3458 | 2019-10-03 |
1609437425 | Sherri Sue Albertson | Nurse Practitioner | 2710 Lake Ave, Fort Wayne, IN 46805-5412 | 2019-06-24 |
1710347059 | Krista Thornberry | Nurse Practitioner | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2016-02-29 |
1639103153 | Irene T Hoover | Nurse Practitioner | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2006-07-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548875669 | Brooke Lavignette | Nurse Practitioner | 1805 Summit Dr, West Lafayette, IN 47906-2231 | 2020-09-15 |
1205444775 | Anu Abraham Ade Owofadeju | Nurse Practitioner | 8820 S Meridian St Ste 225, Indianapolis, IN 46217-6064 | 2020-07-21 |
1356959068 | Indy Behavioral Health LLC | Nurse Practitioner | 2611 Waterfront Parkway East Dr Ste 370, Indianapolis, IN 46214-2069 | 2020-07-20 |
1942833306 | Osasumwen Igbinoba | Nurse Practitioner | 402 Wall St Ste 23, Valparaiso, IN 46383-2567 | 2020-02-13 |
1770114118 | Abbey Bolden | Nurse Practitioner | 929 Miller Ct, Greenfield, IN 46140-7267 | 2020-02-03 |
1376184556 | Carrie Mefford | Nurse Practitioner | 5435 E 16th St, Indianapolis, IN 46218-4869 | 2019-09-30 |
1700430006 | Lusine Vardanyan | Nurse Practitioner | Memorial Hospital and Health Care Center, 800 W 9th Street, Jasper, IN 47546-2514 | 2019-07-25 |
1134780851 | Eric Lyakhovetsky | Nurse Practitioner | 327 W Saidah Rd, Bloomington, IN 47404-8965 | 2019-06-24 |
1124599394 | Adria Dawn Thornburgh | Nurse Practitioner | 6235 Forest View Dr, Indianapolis, IN 46260-4707 | 2018-12-16 |
1033693213 | Katie Marie Feeney | Nurse Practitioner | Riley Children's Hospital, 705 Riley Hospital Dr, Indianapolis, IN 46202 | 2018-09-24 |
Find all providers with the same taxonomy |
City | FORT WAYNE |
Zip Code | 46805 |
Please comment or provide details below to improve the information on TERESA L ROBERTS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.