Mahan-Etheridge, Teresa K

Mahan-Etheridge, Teresa K is an individual health care provider with primary practice located at 3100 E Fletcher Ave , Tampa FL 33613-4613. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Mahan-Etheridge, Teresa K can be contacted via phone (813) 467-4770.

Contact Information

Primary practice address
3100 E Fletcher Ave Tampa FL 33613-4613
Phone: (813) 467-4770
Fax: (813) 467-4243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X APRN9208090 Florida

Profile Details

NPI number 1699070433
LBN Legal business name Mahan-Etheridge, Teresa K
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2011
Last updated May 23rd, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699070433 NPPES
Florida Other Y06M3 BLUE CROSS BLUE SHIELD
Florida MEDICAID 003148500 BLUE CROSS BLUE SHIELD

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