MRS. THERESA ANN FAIRES (NPI# 1629487186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629487186 |
| Entity Type | Individual |
| Full Name | MRS. THERESA ANN FAIRES |
| Credential | RN |
| Practice Address |
142 Sherlock Drive Statesville NC 28625-1953 |
| Mailing Address |
Po Box 1845 Statesville NC 28687-1845 |
| Practice Telephone | 7048388256 |
| Practice Fax Number | 7048388251 |
| Mailing Telephone | 7048388256 |
| Enumeration Date | 2014-08-10 |
| Last Update Date | 2018-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5007409 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
142 SHERLOCK DRIVE |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28625-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861692188 | Charalambos Demetri | Internal Medicine | 142 Sherlock Drive, Statesville, NC 28625-1953 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714163 | Sandra Lourdes Mayta | Counselor | 1450 Fern Creek Drive, Statesville, NC 28625 | 2020-03-05 |
| 1023643582 | Youngchi Chang Dds Pllc | Dentist | 964 Glenway Ave Ste A, Statesville, NC 28625 | 2020-03-05 |
| 1538799200 | Nicole-marie Blischak | Dentist | 964 Glenway Dr, Ste A, Statesville, NC 28625 | 2020-01-22 |
| 1013575257 | Sherry Neilson | Registered Nurse | 524 Signal Hill Rd, Statesville, NC 28625 | 2019-06-03 |
| 1770904328 | Elinor Kyle Tyner | Counselor | 1206 Museum Road, Statesville, NC 28625 | 2013-12-30 |
| 1982031001 | Tamiko Bradley | Counselor | 524 Signal Hill Dr Ext, Statesville, NC 28625 | 2013-10-03 |
| 1487932505 | Nicole Weisner Winecoff | Advanced Practice Midwife | 1420 Fern Creek Drive, Statesville, NC 28625 | 2011-07-22 |
| 1538461967 | Bethany J Sprague | Nurse Practitioner | 2632 Fines Creek Dr, Statesville, NC 28625 | 2010-11-17 |
| 1477789147 | Greenbriar Primary Care, Pa | Nurse Practitioner | 308-c Mocksville Highway, Statesville, NC 28625 | 2009-06-08 |
| 1619122538 | Phasebdevelopment | Substance Abuse Rehabilitation Facility | 113 Bethany Rd, Statesville, NC 28625 | 2008-11-19 |
| Find all providers in zip 28625 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548887706 | Tasha Marie Vangile | Nurse Practitioner | 120 Westview Ln, Statesville, NC 28625-8221 | 2020-07-02 |
| 1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
| 1144626003 | Valorie Stewart Byrd | Nurse Practitioner | 150 Magnolia Hill Ln, Statesville, NC 28677-9735 | 2014-11-05 |
| 1538461967 | Bethany J Sprague | Nurse Practitioner | 2632 Fines Creek Dr, Statesville, NC 28625 | 2010-11-17 |
| 1427362367 | Melissa Stevens Jolly | Nurse Practitioner | 513 Brookdale Dr, Statesville, NC 28677-4107 | 2010-08-03 |
| 1558695213 | Jessica Daniels Wood | Nurse Practitioner | 310 Davie Avenue, Statesville, NC 28677 | 2009-09-29 |
| 1477789147 | Greenbriar Primary Care, Pa | Nurse Practitioner | 308-c Mocksville Highway, Statesville, NC 28625 | 2009-06-08 |
| 1508063355 | Ann Green Moose | Nurse Practitioner | 1893 E Broad St # B-4, Statesville, NC 28625-4307 | 2007-06-27 |
| 1073739843 | Judy Lackey Keighron | Nurse Practitioner | 308c Mocksville Hwy, Statesville, NC 28625-8267 | 2007-04-18 |
| 1578788741 | Beverly B Sproul | Nurse Practitioner | 470 Crawford Rd, Statesville, NC 28625-8545 | 2007-04-14 |
| Find all providers in STATESVILLE | ||||
| City | STATESVILLE |
| Zip Code | 28625 |
Please comment or provide details below to improve the information on MRS. THERESA ANN FAIRES.
| 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.