Provider Demographics
NPI:1699779439
Name:HULME, THERESE M (ARNP)
Entity type:Individual
Prefix:MRS
First Name:THERESE
Middle Name:M
Last Name:HULME
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14499 N DALE MABRY HWY
Mailing Address - Street 2:STE 180-S
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2078
Mailing Address - Country:US
Mailing Address - Phone:813-374-2406
Mailing Address - Fax:813-374-2407
Practice Address - Street 1:1839 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713
Practice Address - Country:US
Practice Address - Phone:727-322-1054
Practice Address - Fax:727-322-2725
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1738562363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00115550OtherRAIL ROAD MEDICARE
FL301847400Medicaid
FLP00115550OtherRAIL ROAD MEDICARE
FLE6042Medicare ID - Type Unspecified