Provider Demographics
NPI:1194058701
Name:ALBRECHT, TERESA ROSE (RN)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ROSE
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9528 SUMAC CIR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:WI
Mailing Address - Zip Code:54406-9290
Mailing Address - Country:US
Mailing Address - Phone:715-824-2596
Mailing Address - Fax:
Practice Address - Street 1:9528 SUMAC CIR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:WI
Practice Address - Zip Code:54406-9290
Practice Address - Country:US
Practice Address - Phone:715-824-2596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI159330-030163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse