Provider Demographics
NPI:1699271015
Name:COON, TERESA NYINGI (RN)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:NYINGI
Last Name:COON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:NYINGI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10827 WOLF CREEK RD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-5917
Mailing Address - Country:US
Mailing Address - Phone:505-440-7126
Mailing Address - Fax:
Practice Address - Street 1:UPLIFT PROFESSIONALS NETWORK
Practice Address - Street 2:3956 TOWN CENTER
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-3283
Practice Address - Country:US
Practice Address - Phone:407-512-0183
Practice Address - Fax:888-717-4335
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-76685163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse