Teresa J Wiersma (NPI# 1417931833, PAC ID# 7618925546) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1417931833 |
| PAC ID by PECOS | 7618925546 |
| Professional Enrollment ID | I20050107000400 |
| Full Name | Teresa J Wiersma |
| Organization Legal Name | RANDOLPH COMMUNITY CLINIC SC |
| Address |
504 S High St Randolph WI 53956-1499 |
| Phone Number | 9203265060 |
| Gender | F |
| Credential | NP |
| Graduation Year | 2004 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1456247311 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520076 | BEAVER DAM COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 504 S High St, Randolph, WI 53956-1499 | 9203265060 | RANDOLPH COMMUNITY CLINIC SC |
| Organization Legal Name | RANDOLPH COMMUNITY CLINIC SC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Elaine Lucarelli | Family Medicine | Randolph Community Clinic Sc | 504 S High St, Randolph, WI 53956-1499 |
| Linda K Mulder | Physician Assistant | Randolph Community Clinic Sc | 504 S High St, Randolph, WI 53956-1499 |
| Street Address |
504 S HIGH ST |
| City | RANDOLPH |
| State | WI |
| Zip | 53956-1499 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Elaine Lucarelli | Family Medicine | Randolph Community Clinic Sc | 504 S High St, Randolph, WI 53956-1499 |
| Linda K Mulder | Physician Assistant | Randolph Community Clinic Sc | 504 S High St, Randolph, WI 53956-1499 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Leslie Jones | Chiropractic | 175 Stark St, Randolph, WI 53956-1243 | |
| Robert V Nagle | Family Medicine | Agnesian Healthcare Inc | 500 S High St, Randolph, WI 53956-1499 |
| City | RANDOLPH |
| Zip Code | 53956 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | RANDOLPH + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Teresa J Wiersma.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.