Provider Demographics
NPI:1194077271
Name:MCDONALD, THERESA ROBERTSON (RN,NNP-BC)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ROBERTSON
Last Name:MCDONALD
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Gender:F
Credentials:RN,NNP-BC
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Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5272
Practice Address - Country:US
Practice Address - Phone:828-254-8232
Practice Address - Fax:828-253-4470
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2016-12-07
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Provider Licenses
StateLicense IDTaxonomies
NC930025363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC9870AMedicare PIN