Provider Demographics
NPI:1124797105
Name:WAINSCOTT, TERESA (PHLEBOTOMY TECH)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:WAINSCOTT
Suffix:
Gender:F
Credentials:PHLEBOTOMY TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:KY
Mailing Address - Zip Code:41040-0342
Mailing Address - Country:US
Mailing Address - Phone:941-879-6117
Mailing Address - Fax:
Practice Address - Street 1:219 LOOP RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:KY
Practice Address - Zip Code:41040-7641
Practice Address - Country:US
Practice Address - Phone:941-879-6117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy