Provider Demographics
NPI:1306546569
Name:CARNEY, TERESA LASHANNA (DNP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LASHANNA
Last Name:CARNEY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:LASHANNA
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP
Mailing Address - Street 1:513 W RED BANK AVE
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1453
Mailing Address - Country:US
Mailing Address - Phone:856-308-0025
Mailing Address - Fax:
Practice Address - Street 1:513 W RED BANK AVE
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-1453
Practice Address - Country:US
Practice Address - Phone:215-829-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN602963163W00000X
NJ26NR14437200163WP2201X
NJ26NJ15007800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care