Provider Demographics
NPI:1396779757
Name:SIROIS, TERESA WEEKS (FNP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:WEEKS
Last Name:SIROIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:MARIE
Other - Last Name:WEEKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302-0911
Mailing Address - Country:US
Mailing Address - Phone:207-303-3200
Mailing Address - Fax:207-250-2140
Practice Address - Street 1:105 TOPSHAM FAIR MALL RD UNIT 1
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1773
Practice Address - Country:US
Practice Address - Phone:207-303-3300
Practice Address - Fax:207-250-2137
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME044600207P00000X
MECNP81326363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME010453642OtherMEDNET
ME268010099Medicaid
ME268010099Medicaid