Provider Demographics
NPI:1194500520
Name:ZAGLIN, TERESSA LORRIE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:TERESSA
Middle Name:LORRIE
Last Name:ZAGLIN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1262 SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-9199
Mailing Address - Country:US
Mailing Address - Phone:404-444-5526
Mailing Address - Fax:
Practice Address - Street 1:1262 SCOTT RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-9199
Practice Address - Country:US
Practice Address - Phone:404-444-5526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN263992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily